| Doctor Name: | DR. JOHN DOMINIC CREDICO |
| NPI Number: | 1023002938 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 35053584 |
| Business Practice Address: | 2751 Bay Park Dr Suite 304 Oregon, OH - 436164921 |
| Business Phone Number: | 4196907611 |
| Business Fax Number: | 4196911511 |
| Mailing Address: | 2751 Bay Park Dr, Suite 304 OREGON |
| State: | OH |
| Postal Code: | 436164921 |
| Phone Number: | 4196907611 |
| Fax Number: | 4196911511 |
| NPI Enumeration Date: | 09/07/2005 |
| NPI Last Update Date: | 03/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VX0000X |
| License Number: | 35053584 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Obstetrics |
| Taxonomy Definition: | |