Individual
JEFFREY P SCAVELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA-C
Contact information
Practice address
29000 CENTER RIDGE RD, WESTLAKE, OH 44145-5293
(440) 827-5000
Mailing address
19250 BAGLEY RD, #101, CLEVELAND, OH 44130-3314
(440) 891-8800
(440) 891-1734
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
667
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000346560
ANTHEM BCBS
OH
05
—
2524512
—
OH
01
—
P00739953
RAILROAD MEDICARE
OH
Enumeration date
08/25/2005
Last updated
12/19/2011
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