Individual
KELCIE CHADIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5154 FULTON DR NW, CANTON, OH 44718-2365
(330) 499-8837
Mailing address
5154 FULTON DR NW, CANTON, OH 44718-2365
(330) 499-8837
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50004288
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50004288
CERTIFICATION
—
Enumeration date
02/18/2015
Last updated
03/17/2018
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