Individual
JUSTIN RICHARD DAVANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2580 HAYMAKER RD STE 106, MONROEVILLE, PA 15146-3500
(412) 858-7766
(412) 858-7769
Mailing address
2580 HAYMAKER RD STE 106, MONROEVILLE, PA 15146-3500
(412) 858-7766
(412) 858-7769
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD457862
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14653990
CAQH
—
Enumeration date
03/24/2013
Last updated
10/01/2020
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