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General NPI Number Information
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NPI Number | 1871619841
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Entity Type | Organization
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Legal Business Name | OHIO VALLEY SURGICAL, ASSOC. INC.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 11/01/2012
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Provider Practice Location Address
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Address Line | 523 N 4TH ST
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City | STEUBENVILLE
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State | OH
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Zip | 43952-1933
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Country | US
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Telephone | 740-282-1144
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Fax | 740-282-2374
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Provider Business Mailing Address
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Address Line | 523 N 4TH ST
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City | STEUBENVILLE
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State | OH
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Zip | 43952-1933
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Country | US
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Telephone | 740-282-1144
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Fax | 740-282-2374
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOMINIC MACEDONIA
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Credential | M.D.
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Telephone | 740-282-1144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 35031012
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License Number State | OH
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