Individual
CHARLES M AMMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
146 WEST 5TH STREET, EAST LIVERPOOL, OH 43920-3734
(330) 382-0165
(330) 382-0275
Mailing address
380 SUMMIT AVENUE MSO PHYSICIAN BILLING, STEUBENVILLE, OH 43952-2667
(740) 283-7597
(740) 283-7460
Taxonomy
Speciality
Code
Description
License number
State
163WF0300X
Flight Registered Nurse
RN270498
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.11984
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060646
—
OH
05
—
3810023079
—
WV
Enumeration date
07/12/2010
Last updated
05/05/2020
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