Provider Demographics
NPI:1497733422
Name:DELROSARIO, ANTONIO J I (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:J
Last Name:DELROSARIO
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6501 E LIVINGSTON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3561
Mailing Address - Country:US
Mailing Address - Phone:614-864-0165
Mailing Address - Fax:614-864-1925
Practice Address - Street 1:6501 E LIVINGSTON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3561
Practice Address - Country:US
Practice Address - Phone:614-751-4288
Practice Address - Fax:614-751-4568
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35033390D207QG0300X, 208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1200123OtherUNITED HEALTH CARE
OH0168278Medicaid
OH000000117257OtherANTHEM
OH000000117257OtherANTHEM
OH0857593Medicare PIN
OHAR4690182OtherDEA