Provider Demographics
NPI:1932183332
Name:CHOPKO, BOHDAN WOLODYMYR (PHD MD)
Entity Type:Individual
Prefix:DR
First Name:BOHDAN
Middle Name:WOLODYMYR
Last Name:CHOPKO
Suffix:
Gender:M
Credentials:PHD MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-2210
Mailing Address - Country:US
Mailing Address - Phone:419-775-1200
Mailing Address - Fax:419-774-1300
Practice Address - Street 1:39 WOOD ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2210
Practice Address - Country:US
Practice Address - Phone:419-775-1200
Practice Address - Fax:419-774-1300
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077905207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2178978Medicaid
OH2178978Medicaid
MI9337651Medicare ID - Type Unspecified