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Individual

DYLAN THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8401 MARKET ST, BOARDMAN, OH 44512-6725
(330) 729-2929
Mailing address
80 WASHINGTON BLVD APT 4, BOARDMAN, OH 44512-6346
(330) 718-4256

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
58.033017
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
236
OH
01
568946544
BCBS
01
5874
HEALTH PARTNERS
Enumeration date
04/06/2022
Last updated
06/27/2022
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