Individual
DR. MARY-HELENE A MASSULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
501 VAN BUREN ST, SUITE 206, FOSTORIA, OH 44830-1534
(419) 436-1035
(419) 436-0765
Mailing address
501 VAN BUREN ST, SUITE 206, FOSTORIA, OH 44830-1534
(419) 436-1035
(419) 436-0765
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34004036
OH
208D00000X
General Practice Physician
34004036
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0786252
—
OH
Enumeration date
12/01/2006
Last updated
05/19/2015
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