Individual
CHARLES G COFFARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 E BUSINESS WAY, SUITE A, CINCINNATI, OH 45241-2374
(513) 354-3700
(513) 354-7651
Mailing address
500 E BUSINESS WAY, SUITE A, CINCINNATI, OH 45241-2374
(513) 354-3700
(513) 354-7651
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003396
OH
363A00000X
Physician Assistant
TC057
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2714110
—
OH
Enumeration date
10/25/2011
Last updated
09/11/2013
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