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Individual

JOSEPH G PROTAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
813 KENTWOOD DR, BOARDMAN, OH 44512-5004
(330) 953-3513
(330) 953-0313
Mailing address
813 KENTWOOD DR, BOARDMAN, OH 44512-5004
(330) 953-3513
(330) 953-0313

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
34-008446
OH
2086S0129X
Vascular Surgery Physician
Primary
34-008446
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2688846
OH
01
P00067987
RR MEDICARE
OH
Enumeration date
05/24/2006
Last updated
06/10/2020
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