Individual
DR. JOSEPH ANGELO FAVAZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
8984 DARROW RD, SUITE 2, TWINSBURG, OH 44087-2186
(216) 245-1290
(866) 571-4884
Mailing address
3733 PARK EAST DR, SUITE 240, BEACHWOOD, OH 44122-4338
(216) 245-1290
(866) 571-4884
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36-003320
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2406524
—
OH
01
—
5315240001
DMERC
OH
Enumeration date
09/16/2005
Last updated
09/07/2011
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