# JOSEPH A FAVAZZO DPM LL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871772038
- **Authorized official:** DR. JOSEPH ANGELO FAVAZZO DPM (OWNER)
- **Authorized official phone:** (330) 963-4880

## Contact information

- **Practice address:** 8984 DARROW ROAD, STE 2, TWINSBURG, OH 44087
- **Practice address phone:** (330) 963-4880
- **Practice address fax:** (440) 461-3279
- **Mailing address:** 8984 DARROW ROAD, STE 2, TWINSBURG, OH 44087
- **Mailing address phone:** (330) 963-4880
- **Mailing address fax:** (440) 461-3279

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 36-003320 | OH | Yes |

## Other

- **Enumeration date:** 10/24/2007
- **Last updated:** 01/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2406524 | — | OH |
| 01 | — | 5315240001 | DMERC | OH |
| 01 | — | J09334871 | MEDICARE GROUP NUMBER | OH |
| 01 | — | P00044963 | MEDICARE RAILROAD | OH |