Healthcare Provider Details

I. General information

NPI: 1265742357
Provider Name (Legal Business Name): CIRCULATORY CENTERS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 BREEZEPORT WAY SUITE 100
SUFFOLK VA
23435-3727
US

IV. Provider business mailing address

397 CHURCHILL HUBBARD RD
YOUNGSTOWN OH
44505-1375
US

V. Phone/Fax

Practice location:
  • Phone: 800-526-3082
  • Fax: 330-759-6755
Mailing address:
  • Phone: 330-759-6760
  • Fax: 330-759-6755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101040623
License Number StateVA

VIII. Authorized Official

Name: DR. LOUIS MICHAEL CERTO
Title or Position: OWNER
Credential: M.D.
Phone: 412-967-9220