Healthcare Provider Details

I. General information

NPI: 1609825157
Provider Name (Legal Business Name): CHRISTOPHER E KOBUS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 N UNION ST STE 104
AKRON OH
44304-1369
US

IV. Provider business mailing address

190 N UNION ST STE 104
AKRON OH
44304-1369
US

V. Phone/Fax

Practice location:
  • Phone: 330-253-9145
  • Fax: 330-253-6222
Mailing address:
  • Phone: 330-253-9145
  • Fax: 330-253-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN-186848
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: