Organization
EAR NOSE THROAT HEAD & NECK SURGEONS OF NE OHIO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J VIETTI M.D. (PRESIDENT)
(419) 522-9952
Entity
Organization
Contact information
Practice address
558 S TRIMBLE RD, MANSFIELD, OH 44906-3418
(419) 522-9952
(419) 522-7050
Mailing address
558 S TRIMBLE RD, MANSFIELD, OH 44906-3418
(419) 522-9952
(419) 522-7050
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
35069405
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2123044
—
OH
01
—
CH0644
RR MEDICARE
OH
Enumeration date
02/26/2007
Last updated
11/05/2010
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