Healthcare Provider Details

I. General information

NPI: 1114997871
Provider Name (Legal Business Name): LOUIS MICHAEL CHIARO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7629 MARKET STREET SUITE 100
YOUNGSTOWN OH
44460-2914
US

IV. Provider business mailing address

107 ROYAL BIRKDALE DR SUITE A
COLUMBIANA OH
44408-8493
US

V. Phone/Fax

Practice location:
  • Phone: 330-332-5232
  • Fax: 330-332-4771
Mailing address:
  • Phone: 330-482-9350
  • Fax: 330-482-5695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36002980
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: