Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 35-047016 | OH |
N | 208600000X | Surgeon | 35-047016 | OH |
N | 2086S0129X | Vascular Surgeon | 35-047016 | OH |
N | 208C00000X | Colorectal Surgeon | 35-047016 | OH |
NPI | 1164427639 |
---|---|
Provider Name | Dr. Warren H Kofol |
First Address | Massillon, OH 44646-2371 |
Second Address | Massillon, OH 44646-2371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0638804 | (05) | OH |
A82292 | (02) | OH |