Individual
JACQUELINE KATHRYN DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
23175 COMMERCE PARK STE C, BEACHWOOD, OH 44122-5806
(216) 299-6774
(440) 583-3097
Mailing address
23175 COMMERCE PARK STE C, BEACHWOOD, OH 44122-5806
(216) 299-6774
(440) 583-3097
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
36.003737
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36003737
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0424757
—
OH
Enumeration date
04/11/2012
Last updated
10/18/2023
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