Provider Demographics
NPI:1609097971
Name:COUNTO, VIDYA J (MD)
Entity Type:Individual
Prefix:DR
First Name:VIDYA
Middle Name:J
Last Name:COUNTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2525 SOUTHEAST BLVD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-3464
Mailing Address - Country:US
Mailing Address - Phone:330-482-3871
Mailing Address - Fax:330-482-0133
Practice Address - Street 1:116 CARRIAGE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-8306
Practice Address - Country:US
Practice Address - Phone:330-482-3871
Practice Address - Fax:330-482-0133
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35088975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2794169Medicaid
OH2794169Medicaid
OHPENDINGMedicaid