Provider Demographics
NPI:1578659025
Name:TIRMONIA, MICHAEL VIRGIL (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:VIRGIL
Last Name:TIRMONIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1330 MERCY DR NW STE 324
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-2625
Mailing Address - Country:US
Mailing Address - Phone:330-489-1428
Mailing Address - Fax:330-430-2761
Practice Address - Street 1:1330 MERCY DR NW STE 324
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2625
Practice Address - Country:US
Practice Address - Phone:330-489-1428
Practice Address - Fax:330-430-2761
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2023-10-25
Deactivation Date:
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Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.006209207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHG47139Medicare UPIN