Organization Name: | PAOLO C GIACOMINI, M.D. PC |
NPI Number: | 1790940476 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAOLO C. GIACOMINI C GIACOMINI (OWNER) |
Mailing Address: | 400 Ash St Wabash |
State: | IN US |
Postal Code: | 469921954 |
Phone Number: | 2605638875 |
Fax Number: | 2605699803 |
NPI Enumeration Date: | 07/22/2008 |
NPI Last Update Date: | 07/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01038356 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |