Individual
DR. LAURENCE W SPIVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
9330 HIDDEN GLEN DR, MENTOR, OH 44060
(440) 487-3947
(513) 858-7827
Mailing address
9330 HIDDEN GLEN DR, MENTOR, OH 44060-7362
(440) 487-3947
(513) 858-7827
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36001535
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000242733
ANTHEM
OH
05
—
0161999
—
OH
01
—
016307
UNITED HEALTHCARE
OH
Enumeration date
06/16/2005
Last updated
07/21/2022
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