Individual
DR. DOMINIC NEAL MASTRUSERIO
Active
Individual
DR. DOMINIC NEAL MASTRUSERIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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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