Provider Demographics
NPI:1356345300
Name:CORTESE, FERDINANDO (MD)
Entity type:Individual
Prefix:DR
First Name:FERDINANDO
Middle Name:
Last Name:CORTESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 S SAWBURG RD
Mailing Address - Street 2:STE 110
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-5905
Mailing Address - Country:US
Mailing Address - Phone:330-829-4234
Mailing Address - Fax:330-829-4209
Practice Address - Street 1:885 S SAWBURG RD
Practice Address - Street 2:STE 110
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-5905
Practice Address - Country:US
Practice Address - Phone:330-829-4234
Practice Address - Fax:330-829-4209
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0H35-05-4338C207RX0202X
OH35054338C207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0640819Medicaid
A82524Medicare UPIN
OH0640819Medicaid