Provider Demographics
NPI:1043218100
Name:CHOBAN, PATRICIA S (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:CHOBAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 MOUNT CARMEL MALL
Mailing Address - Street 2:SUITE 380
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43222-1553
Mailing Address - Country:US
Mailing Address - Phone:614-228-0768
Mailing Address - Fax:614-545-2997
Practice Address - Street 1:750 MOUNT CARMEL MALL
Practice Address - Street 2:SUITE 380
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1553
Practice Address - Country:US
Practice Address - Phone:614-228-0768
Practice Address - Fax:614-545-2997
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061825208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F13536Medicare UPIN
OHCH0698346Medicare PIN
OH0839089Medicare ID - Type Unspecified