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Individual

BIJO JOS THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-3658
(330) 480-3439
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35.127294
OH
207L00000X
Anesthesiology Physician
MD431904
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000981074
ANTHEM BCBS
OH
05
0154046
OH
05
1020110240002
PA
01
13675164
CAQH
OH
01
H323470
MEDICARE PTAN
OH
01
P016533074
MEDICARE RAILROAD
OH
Enumeration date
06/18/2007
Last updated
12/10/2019
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