Organization
MICHAEL TIRMONIA, DO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL VIRGIL TIRMONIA D.O. (PRESIDENT/OWNER)
(330) 489-1428
Entity
Organization
Contact information
Practice address
1330 MERCY DR NW STE 324, CANTON, OH 44708-2625
(330) 489-1428
(330) 430-2761
Mailing address
1330 MERCY DR NW STE 324, CANTON, OH 44708-2625
(330) 489-1428
(330) 430-2761
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
34-00-6209-T
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0820561
MEDICARE IDENTIFICATION NUMBER
OH
01
—
36D0917207
CLIA NUMBER
OH
Enumeration date
03/23/2010
Last updated
03/23/2010
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