Provider Demographics
NPI:1437132933
Name:GIANETTI, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:GIANETTI
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 1:20 OHLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2331
Mailing Address - Country:US
Mailing Address - Phone:330-797-9705
Mailing Address - Fax:330-270-5997
Practice Address - Street 1:20 OHLTOWN RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2331
Practice Address - Country:US
Practice Address - Phone:330-797-9705
Practice Address - Fax:330-270-5997
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-059237207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0854311Medicaid
OH4080262Medicare PIN
OH9324101Medicare ID - Type Unspecified
OH0854311Medicaid