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Individual

DR. CHARLES PENVOSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1920 TAMARACK RD, NEWARK, OH 43055-2303
(740) 344-8286
(740) 522-0094
Mailing address
1920 TAMARACK RD, NEWARK, OH 43055-2303
(740) 344-8286
(740) 522-0094

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36.003998
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
POD001444
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0444143
OH
Enumeration date
02/13/2020
Last updated
10/22/2025
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