Provider Demographics
NPI:1609859214
Name:MINOTTI, ARMAND LOUIS (DO)
Entity Type:Individual
Prefix:DR
First Name:ARMAND
Middle Name:LOUIS
Last Name:MINOTTI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9471 MARKET ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTH LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:44452-8702
Mailing Address - Country:US
Mailing Address - Phone:330-729-2388
Mailing Address - Fax:330-629-6468
Practice Address - Street 1:9471 MARKET ST
Practice Address - Street 2:STE A
Practice Address - City:NORTH LIMA
Practice Address - State:OH
Practice Address - Zip Code:44452
Practice Address - Country:US
Practice Address - Phone:330-726-7100
Practice Address - Fax:330-758-0347
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-3677M207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0626013Medicaid
OH0557275Medicare UPIN
OH0557274Medicare ID - Type Unspecified