Healthcare Provider Details

I. General information

NPI: 1437619038
Provider Name (Legal Business Name): CHRISTOPHER DANIEL REPETSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 07/07/2022
Certification Date: 02/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 INDEPENDENCE AVE
AKRON OH
44310-1812
US

IV. Provider business mailing address

1260 INDEPENDENCE AVE
AKRON OH
44310-1812
US

V. Phone/Fax

Practice location:
  • Phone: 234-312-2140
  • Fax: 234-312-2304
Mailing address:
  • Phone: 234-312-2140
  • Fax: 234-312-2304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.143034
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: