Provider Demographics
NPI:1467886754
Name:DELMEDICO, MONICA BERKEMEIER (PA-C)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:BERKEMEIER
Last Name:DELMEDICO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 CORPORATE EXCHANGE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-7651
Mailing Address - Country:US
Mailing Address - Phone:614-505-7633
Mailing Address - Fax:
Practice Address - Street 1:1939 W STATE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-3522
Practice Address - Country:US
Practice Address - Phone:330-238-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-22
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007317363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant