Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 2773 | OH |
NPI | 1043232341 |
---|---|
Provider Name | Christopher J Bohach |
First Address | Sandusky, OH 44871-0378 |
Second Address | Willard, OH 44890-9155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 27/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0960349 | (05) | OH |
480015751 | RAILROAD MEDICARE (01) | OH |
U47414 | (02) | OH |