Provider Demographics
NPI:1649746124
Name:ESPINOSA-SETCHKO, BO ELIZABETH (MD, MPP)
Entity Type:Individual
Prefix:MRS
First Name:BO
Middle Name:ELIZABETH
Last Name:ESPINOSA-SETCHKO
Suffix:
Gender:F
Credentials:MD, MPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13241 RAVENNA RD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9012
Mailing Address - Country:US
Mailing Address - Phone:440-285-9166
Mailing Address - Fax:
Practice Address - Street 1:13241 RAVENNA RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9012
Practice Address - Country:US
Practice Address - Phone:440-285-9166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.135013208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics