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Contact Information

PENELOPE MASHBURN, DO
27 ST. LAWRENCE DR.
SUITE203
TIFFIN, OH44883
 Phone: 305-575-9978
 Fax: 419-455-8564
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for PENELOPE MASHBURN · (Female)

NPI Number 1154650117
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 12/21/2009
Last updated 09/29/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # P12-00612
  • OH License # 34.011231
  • OH Medicaid 0106134
  • OH Other 34011231 OHIO MEDICAL LICENSE
Hospital affiliation(s)
  • TRUMBULL MEMORIAL HOSPITAL - (Acute Care)
    1350 EAST MARKET STREET
    WARREN, OH 44482
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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