Credico, John Dominic

Credico, John Dominic is an sole proprietor health care provider with primary practice located at 2751 Bay Park Dr Suite 304, Oregon OH 43616-4921. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics, which is considered as his primary health care specialty. Credico, John Dominic can be contacted via phone (419) 690-7611.

Contact Information

Primary practice address
2751 Bay Park Dr Suite 304 Oregon OH 43616-4921
Fax: (419) 691-1511
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 35053584 Ohio

Profile Details

NPI number 1023002938
LBN Legal business name Credico, John Dominic
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 7th, 2005
Last updated Mar 11th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023002938 NPPES
Ohio MEDICAID 0601405

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