Provider Demographics
NPI:1639118870
Name:CEBUL, DENNIS RAY (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:RAY
Last Name:CEBUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6482 E. MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068
Mailing Address - Country:US
Mailing Address - Phone:614-856-0327
Mailing Address - Fax:614-856-3300
Practice Address - Street 1:495 COOPER RD
Practice Address - Street 2:SUITE 420
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:614-839-5555
Practice Address - Fax:614-839-5100
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35036073207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA77743Medicare UPIN
OHCE0822682Medicare ID - Type Unspecified