Individual
DR. NATHANIEL CHARTER CEVASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9075 TOWN CENTRE DR, SUITE 3, BROADVIEW HTS, OH 44147-4044
(440) 526-4570
(440) 526-4149
Mailing address
2500 W STRUB RD, SUITE 330, SANDUSKY, OH 44870-5390
(416) 926-6700
(419) 626-6710
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35094669
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3052351
—
OH
Enumeration date
08/20/2007
Last updated
06/26/2012
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