Basic Information
| Provider Information | |||||||||
| NPI: | 1518998376 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHOBAN | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4605 SAWMILL RD | ||||||||
| Address2: | |||||||||
| City: | UPPER ARLINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432202246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148278700 | ||||||||
| FaxNumber: | 6148278701 | ||||||||
| Practice Location | |||||||||
| Address1: | 460 W CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | DELAWARE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430151405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403698751 | ||||||||
| FaxNumber: | 7403637265 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 12/10/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | 35061893 | OH | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0799668 | 05 | OH | MEDICAID | 9935131 | 01 | OH | MEDICARE | OTHER |