Individual provider · NPI-1

Theodore Douglas Chrobak, DO

Family Medicine · East Liverpool, OH

NPI number1245218478

StatusActive

Last updated in NPPESSep 22, 2008

Details

NPI: 1245218478
Entity type: Individual (NPI-1)
Name: Theodore Douglas Chrobak
Credential: DO
Sex: Male
Sole proprietor: No
Enumeration date: Jan 6, 2006
Last updated: Sep 22, 2008

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	34006156C	OH	Yes
207Q00000X	Family Medicine	05008296L	PA
2083X0100X	Preventive Medicine, Occupational Medicine	34006156C	OH
2083X0100X	Preventive Medicine, Occupational Medicine	05008296L	PA

Practice location

332 W 6th St
East Liverpool, OH 43920-2812

Phone 330-386-6339 · Fax 330-386-1224

Mailing address

Po Box 856
East Liverpool, OH 43920-5856

Phone 330-386-6339 · Fax 330-386-1224

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