Organization
ENDOCRINOLOGY ASSOCIATES OF OHIO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DEROSA D.O. (PROPRIETOR)
(330) 702-1310
Entity
Organization
Contact information
Practice address
3694 STARRS CENTRE DR, CANFIELD, OH 44406-9514
(330) 702-1310
Mailing address
3694 STARRS CENTRE DR, CANFIELD, OH 44406-9514
(330) 702-1310
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
34008028D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD8266
RAILROADMEDICARE
OH
Enumeration date
02/19/2007
Last updated
08/22/2020
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