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NPI Code Detail

MEDICARE: DR. JON DOMINIC OLIVERIO DPM

MEDICARE:  DR. JON DOMINIC OLIVERIO  DPM
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
1213E00000XPodiatrist36-00-2891-0OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01815036OTHEROHRAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1710985163
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JON DOMINIC OLIVERIO DPM
Provider Business Mailing Address
First Line : 1193 NORTON AVE
Second Line : SUITE D
City : NORTON
State : OH
Zip : 44203-9516
Country : US
Telephone Number : 330-825-7878
Fax Number : 330-595-4729
Provider Business Practice Location Address
First Line : 1193 NORTON AVE
Second Line : SUITE D
City : NORTON
State : OH
Zip : 44203-9516
Country : US
Telephone Number : 330-825-7878
Fax Number : 330-595-4729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 08/01/2017

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Directions to “ DR. JON DOMINIC OLIVERIO DPM” Practice Location

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