Provider Demographics
NPI:1790774842
Name:TAMBURRO, LEONARD D (DO)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:D
Last Name:TAMBURRO
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 1:3515 MASSILLON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7854
Mailing Address - Country:US
Mailing Address - Phone:234-271-3353
Mailing Address - Fax:216-472-2740
Practice Address - Street 1:133 WILBUR DR NE
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1641
Practice Address - Country:US
Practice Address - Phone:330-494-6012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004173207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341773700-00OtherBUREAU OF WORKERS COMP
OH000000030872OtherANTHEM
OH341773700031OtherCARESOURCE
OH080176230OtherRAILROAD MCR
OH0670760Medicaid
OH341773700-00OtherBUREAU OF WORKERS COMP
OH0600791Medicare PIN
OHH233181Medicare PIN