Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 35.138407 | OH |
NPI | 1013371152 |
---|---|
Provider Name | Ryan Edward Chenevey |
First Address | Wooster, OH 44691-1241 |
Second Address | Wooster, OH 44691-1241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2016 |
Last Update Date | 15/12/2020 |