Provider Demographics
NPI:1255836458
Name:BOBOVNYIK, BRITTANY ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:ANN
Last Name:BOBOVNYIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3660 STUTZ DR STE 102
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-8149
Mailing Address - Country:US
Mailing Address - Phone:330-702-1585
Mailing Address - Fax:330-702-1383
Practice Address - Street 1:3660 STUTZ DR STE 102
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-8149
Practice Address - Country:US
Practice Address - Phone:330-702-1585
Practice Address - Fax:330-702-1383
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014889207Q00000X
OH58.030152207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0415762Medicaid