Provider Demographics
NPI:1841419421
Name:CHERFAN, VICTOR JOSEPH JR (DO)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JOSEPH
Last Name:CHERFAN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:901 KIMOLE LN
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1491
Mailing Address - Country:US
Mailing Address - Phone:419-264-0590
Mailing Address - Fax:517-264-5728
Practice Address - Street 1:725 S SHOOP AVE
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-1702
Practice Address - Country:US
Practice Address - Phone:419-330-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016426207V00000X
OH34.010421207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
9854441OtherAETNA
05740OtherPARAMOUNT
MI177077OtherGLHP
OH2963306Medicaid
54585OtherHPM
MI177077OtherGLHP