Provider Demographics
NPI:1407887078
Name:SOLOMITO, JOSEPH A (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:SOLOMITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 KETTERING BLVD BLDG B3
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3188
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:5275 STATE ROUTE 122 STE 200
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-9617
Practice Address - Country:US
Practice Address - Phone:513-217-6400
Practice Address - Fax:513-217-6037
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056016207RC0000X, 207RC0000X
LA05830R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0712625Medicaid
OH0712625Medicaid
OHSO4109622Medicare PIN