Provider Demographics
NPI:1083988083
Name:CHRISTMAN, PAUL WILLIAM
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:WILLIAM
Last Name:CHRISTMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 N RIDGE RD E
Mailing Address - Street 2:APT1
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-8232
Mailing Address - Country:US
Mailing Address - Phone:440-318-4314
Mailing Address - Fax:
Practice Address - Street 1:4410 N RIDGE RD E
Practice Address - Street 2:APT1
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-8232
Practice Address - Country:US
Practice Address - Phone:440-318-4314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH400035181001OtherSTATE TESTED NURSING ASSISTANT