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Individual

ROGER BASILETTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
875 8TH ST NE, MASSILLON, OH 44646-8503
(330) 493-4443
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(330) 493-4443

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
50.000363
OH
363A00000X
Physician Assistant

Other

Enumeration date
02/08/2007
Last updated
05/15/2015
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