Individual
AMMIE MARAVELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
667 EASTLAND AVE SE, WARREN, OH 44484-4503
(330) 841-4029
(330) 656-5901
Mailing address
5700 DARROW RD, SUITE 106, HUDSON, OH 44236-5021
(330) 656-5911
(330) 656-5901
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OH
Enumeration date
07/05/2006
Last updated
07/08/2007
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