Individual
DR. CHARLES JOHN GARVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11851 DETROIT AVE, LAKEWOOD, OH 44107-3016
(216) 529-7125
(216) 529-7196
Mailing address
11851 DETROIT AVE, LAKEWOOD, OH 44107-3016
(216) 529-7125
(216) 529-7196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35055675
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000480954
ANTHEM BC/BS
OH
05
—
0808666
—
OH
01
—
341542312138
CARESOURCE
OH
01
—
P00705931
RAILROAD CARE
OH
Enumeration date
01/20/2006
Last updated
06/26/2009
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