Individual
BLOSSOM MARIMPIETRI HEINDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3838 MASSILLON RD, UNIONTOWN, OH 44685-7964
(330) 835-5533
Mailing address
3838 MASSILLON RD, UNIONTOWN, OH 44685-7964
(330) 835-5533
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34.012411
OH
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
34.012411
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0121949
—
OH
Enumeration date
04/16/2014
Last updated
10/26/2018
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