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Individual

JOHN COLOMBO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
205 E PALMER RD, BELLEFONTAINE, OH 43311-2281
(937) 592-9545
(937) 592-9790
Mailing address
PO BOX 1024, BELLEFONTAINE, OH 43311-6024
(937) 592-9545
(937) 592-9790

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000202531
ANTHEM
OH
05
0186105
OH
Enumeration date
07/17/2006
Last updated
07/09/2007
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