Provider Demographics
NPI:1114997871
Name:CHIARO, LOUIS MICHAEL (DPM)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:MICHAEL
Last Name:CHIARO
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 1:107 ROYAL BIRKDALE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-8493
Mailing Address - Country:US
Mailing Address - Phone:330-482-9350
Mailing Address - Fax:330-482-5695
Practice Address - Street 1:7629 MARKET STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44460-2914
Practice Address - Country:US
Practice Address - Phone:330-332-5232
Practice Address - Fax:330-332-4771
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002980213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2035783Medicaid
OH2035783Medicaid
OHCH0893754Medicare PIN
OH4265510001Medicare NSC