Individual
LEO CLAVECILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2040 E MARKET ST, AKRON, OH 44312-1100
(330) 784-2224
(330) 784-4021
Mailing address
525 E MARKET ST, PO BOX 2090, AKRON, OH 44304-1619
(330) 996-0347
(330) 996-0359
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-068869C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0416428
—
OH
01
—
0805314
MEDICARE ID
OH
01
—
480
SUMMACARE
OH
01
—
729745
BUCKEYE COMMUNITY HEALTH
OH
Enumeration date
03/24/2006
Last updated
04/24/2013
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