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Organization

LODI MEDICAL GROUP INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GRACIANO B DICHOSO M.D. (OWNER)
(330) 948-1555
Entity
Organization

Contact information

Practice address
402 HIGHLAND DR, LODI, OH 44254-1216
(330) 948-1555
(330) 948-2676
Mailing address
402 HIGHLAND DR, LODI, OH 44254-1216
(330) 948-1555
(330) 948-2676

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35033396
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0185508
OH
Enumeration date
04/26/2007
Last updated
08/22/2020
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