Provider Demographics
NPI:1952930877
Name:DEMARTINI, OLIVIA (DO)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:DEMARTINI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 CORPORATE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4442
Mailing Address - Country:US
Mailing Address - Phone:330-633-3883
Mailing Address - Fax:330-253-8629
Practice Address - Street 1:1320 CORPORATE DR STE 200
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4442
Practice Address - Country:US
Practice Address - Phone:330-633-3883
Practice Address - Fax:330-253-8629
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.016771207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine