Provider Demographics
NPI:1891725537
Name:STETLER, CHRISTOPHER RYAN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RYAN
Last Name:STETLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11932 KING CHURCH AVENUE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44685
Mailing Address - Country:US
Mailing Address - Phone:330-877-0781
Mailing Address - Fax:330-877-0492
Practice Address - Street 1:11932 KING CHURCH AVE NW
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-8220
Practice Address - Country:US
Practice Address - Phone:330-877-0781
Practice Address - Fax:330-877-0492
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008383207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2704514Medicaid
OH2157366OtherMEDICAID GROUP
OH2704514Medicaid
OH2157366OtherMEDICAID GROUP