Provider Demographics
NPI:1083935936
Name:NERONE, VINCENT STUART (DPM)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:STUART
Last Name:NERONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:805 FARSON ST.
Practice Address - Street 2:SUITE 113
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714
Practice Address - Country:US
Practice Address - Phone:740-423-3207
Practice Address - Fax:740-423-3227
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003670213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0086628Medicaid
OHP01306389OtherRAILROAD MEDICARE - MHCPI
WV3810026352Medicaid
OH0086628Medicaid
OHP01306389OtherRAILROAD MEDICARE - MHCPI