Detesco, Thomas Nicholas

Detesco, Thomas Nicholas is an individual health care provider with primary practice located at 7341 Eisenhower Dr , Boardman OH 44512-5900. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Detesco, Thomas Nicholas can be contacted via phone (330) 726-1138.

Contact Information

Primary practice address
7341 Eisenhower Dr Boardman OH 44512-5900
Phone: (330) 726-1138
Fax: (330) 726-6128
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35100173D Ohio

Profile Details

NPI number 1013911403
LBN Legal business name Detesco, Thomas Nicholas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Mar 7th, 2023 - about 3 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 1013911403 NPPES
Ohio Other 35100173D LICENSE
Ohio MEDICAID 0359348 LICENSE

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