Individual
DR. IOANNA KANELLITSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
433 W HIGH ST, BRYAN, OH 43506-1690
(419) 633-0755
(419) 633-0758
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-6172
(814) 371-3921
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35.077266
OH
207V00000X
Obstetrics & Gynecology Physician
C1-0028672
DE
207V00000X
Obstetrics & Gynecology Physician
Primary
MD451406
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102920926
—
PA
01
—
353894
MEDICARE PTAN- INDIVIDUAL
PA
Enumeration date
10/23/2006
Last updated
10/02/2025
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