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NPI Code Detail

MEDICARE: CHARLES E BOHMAN O.D.

MEDICARE:   CHARLES E BOHMAN  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3280T365OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811981376
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES E BOHMAN O.D.
Provider Business Mailing Address
First Line : 91 E MARION ST
Second Line :
City : MOUNT GILEAD
State : OH
Zip : 43338-1434
Country : US
Telephone Number : 419-946-6881
Fax Number : 419-946-6871
Provider Business Practice Location Address
First Line : 91 E MARION ST
Second Line :
City : MOUNT GILEAD
State : OH
Zip : 43338-1434
Country : US
Telephone Number : 419-946-6881
Fax Number : 419-946-6871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 10/17/2007

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Directions to “ CHARLES E BOHMAN O.D.” Practice Location

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