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Contact Information

KENNETH R MAZER
6847 N CHESTNUT ST
RAVENNA, OH44266-3929
 Phone: 330-493-4443
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Independent Duty Corpsman

1710I1002X
Indicates primary specialty

NPI Profile & details for KENNETH R MAZER · (Male)

NPI # 1558565929
Status Active
Credentials
Entity Individual
Enumeration date 06/12/2007
Last updated 09/11/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • OH License # 50.003940RX
Hospital affiliation(s) Not Available
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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