Provider Demographics
NPI:1093219024
Name:FEMANO, PHILIP ANTHONY III (DO)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ANTHONY
Last Name:FEMANO
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AMANDA FOUTS; MEDICAL EDUCATION
Mailing Address - Street 2:2600 6TH ST SW
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710
Mailing Address - Country:US
Mailing Address - Phone:330-363-6326
Mailing Address - Fax:
Practice Address - Street 1:AMANDA FOUTS; MEDICAL EDUCATION
Practice Address - Street 2:2600 6TH ST SW, CANTON, OH 44710
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710
Practice Address - Country:US
Practice Address - Phone:330-363-6326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program