Provider Demographics
NPI:1205055407
Name:D'ANTONIO, JAMES DANIEL (MD, FSCAI)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DANIEL
Last Name:D'ANTONIO
Suffix:
Gender:M
Credentials:MD, FSCAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-2901
Mailing Address - Country:US
Mailing Address - Phone:330-382-0165
Mailing Address - Fax:330-382-0275
Practice Address - Street 1:146 W 5TH ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2901
Practice Address - Country:US
Practice Address - Phone:330-382-0165
Practice Address - Fax:330-382-0275
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.142689207RC0000X, 207RI0011X
PAMD426483207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0429298Medicaid
AZBD8903230OtherDEA
AZBD8903230OtherDEA