Dr Thomas Nicholas Detesco, MD | |
7341 Eisenhower Dr, Boardman, OH 44512-5900 | |
(330) 726-1138 | |
(330) 726-6128 |
Full Name | Dr Thomas Nicholas Detesco |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 7341 Eisenhower Dr, Boardman, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013911403 | NPI | - | NPPES |
35100173D | Other | OH | LICENSE |
0359348 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 35100173D (Ohio) | Primary |
Entity Name | Ohio North East Health Systems Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700917267 PECOS PAC ID: 1951395086 Enrollment ID: O20131028001143 |
Mailing Address | Practice Location Address |
---|---|
Dr Thomas Nicholas Detesco, MD 7341 Eisenhower Dr, Boardman, OH 44512-5900 Ph: (330) 726-1138 | Dr Thomas Nicholas Detesco, MD 7341 Eisenhower Dr, Boardman, OH 44512-5900 Ph: (330) 726-1138 |
Mrs. Jessica Harriman Austin, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8401 Market St, Boardman, OH 44512 Phone: 330-729-4298 Fax: 330-480-2926 | |
Dr. Thomas E Hunt, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 7206 Market St Ste 100a, Boardman, OH 44512 Phone: 330-726-3379 Fax: 330-726-8683 | |
Dr. Keith Layne Henson, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8401 Market Street, C/o Medical Staff Office, Boardman, OH 44512 Phone: 330-533-5699 Fax: 330-702-1144 | |
Amer Aldamouk, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8401 Market St, Boardman, OH 44512 Phone: 330-729-4298 Fax: 330-729-1897 | |
Manuel M Bautista, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 960 Windham Ct, Suite 1, Boardman, OH 44512 Phone: 330-726-3357 Fax: 330-726-1465 | |
Dr. Abhay Sharma, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8401 Market St, Boardman, OH 44512 Phone: 330-729-4298 Fax: 330-729-1591 |