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General NPI Number Information
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NPI Number | 1306831953
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Entity Type | Individual
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Provider Name | ANTONIOS E CHRYSSOS MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 6659 FRANK AVE NW
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City | NORTH CANTON
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State | OH
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Zip | 44720
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Country | US
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Telephone | 330-966-3772
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Fax | 330-966-3799
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Provider Business Mailing Address
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Address Line | 3100 MACCORKLE AVE SE STE 101
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City | CHARLESTON
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State | WV
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Zip | 25304-1215
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Country | US
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Telephone | 330-966-3772
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Fax | 330-966-3799
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 28147
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License Number State | WV
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