Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.122547 | OH |
Y | 2080P0210X | Pediatric Nephrologist | 35.122547 | OH |
NPI | 1659661734 |
---|---|
Provider Name | Charles David Varnell JR. |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 15/05/2018 |