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Individual

DR. DOMINIC NEAL MASTRUSERIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
941 CHATHAM LANE, SUITE 323, COLUMBUS, OH 43221
(614) 442-6647
(614) 442-6648
Mailing address
941 CHATHAM LN, SUITE 323, COLUMBUS, OH 43221-2416
(614) 442-6647
(614) 442-6648

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35072392M
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000130128
ANTHEM
01
0300516
UHC
01
2309291
AETNA
Enumeration date
05/17/2006
Last updated
01/28/2013
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