Provider Demographics
NPI:1467563874
Name:CANNONE, SEAN C (DO)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:C
Last Name:CANNONE
Suffix:
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 1:4645 REMMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1181
Mailing Address - Country:US
Mailing Address - Phone:330-328-4570
Mailing Address - Fax:330-529-4554
Practice Address - Street 1:4645 REMMINGTON AVE
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1181
Practice Address - Country:US
Practice Address - Phone:330-328-4570
Practice Address - Fax:330-529-4554
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007107207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2197117Medicaid
OH2197117Medicaid