Provider Demographics
NPI:1851089338
Name:KUZMA, ANDREW CHRISTOPHER
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:CHRISTOPHER
Last Name:KUZMA
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 1:1345 SHAWNEE TRL
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-5354
Mailing Address - Country:US
Mailing Address - Phone:330-402-4075
Mailing Address - Fax:
Practice Address - Street 1:1020 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3428
Practice Address - Country:US
Practice Address - Phone:419-289-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008444RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant