Provider Demographics
NPI:1598763328
Name:OLIVETI, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:OLIVETI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1790 TOWN PARK BLVD
Mailing Address - Street 2:STE I
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7972
Mailing Address - Country:US
Mailing Address - Phone:330-899-0300
Mailing Address - Fax:330-899-9430
Practice Address - Street 1:1790 TOWN PARK BLVD
Practice Address - Street 2:STE I
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7972
Practice Address - Country:US
Practice Address - Phone:330-899-0300
Practice Address - Fax:330-899-9430
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350591020174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0774658Medicaid
OH000000115686OtherBLUE CROSS/BLUE SHIELD
OH729915OtherBUCKEYE COMMUNITY HEALTH
OH0774658Medicaid