Penvose, Charles

Penvose, Charles is an sole proprietor health care provider with primary practice located at 1920 Tamarack Rd , Newark OH 43055-2303. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Penvose, Charles can be contacted via phone (740) 344-8286.

Contact Information

Primary practice address
1920 Tamarack Rd Newark OH 43055-2303
Phone: (740) 344-8286
Fax: (740) 522-0094
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X POD001444 Georgia
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 36.003998 Ohio

Profile Details

NPI number 1144853649
LBN Legal business name Penvose, Charles
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2020
Last updated Jun 10th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144853649 NPPES
Ohio MEDICAID 0444143

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