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NPI Code Detail

MEDICARE: ERNEST DEGIDIO DO

MEDICARE: ERNEST DEGIDIO DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician34008333DOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000378866OTHEROHANTHEM BCBS

General Provider Information

NPI Number : 1386622298
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERNEST DEGIDIO DO
Provider Business Mailing Address
First Line : 5001 TRANSPORTATION DR
Second Line : SUITE 300
City : SHEFFIELD VILLAGE
State : OH
Zip : 44054-2849
Country : US
Telephone Number : 440-328-3420
Fax Number : 216-201-6365
Provider Business Practice Location Address
First Line : 5001 TRANSPORTATION DR
Second Line : SUITE 300
City : SHEFFIELD VILLAGE
State : OH
Zip : 44054-2849
Country : US
Telephone Number : 440-328-3420
Fax Number : 216-201-6365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 12/15/2020

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