Individual
DR. MARK E DAVANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
477 COOPER RD, SUITE 440, WESTERVILLE, OH 43081-8053
(380) 898-5561
(380) 898-5563
Mailing address
477 COOPER RD, SUITE 440, WESTERVILLE, OH 43081-8053
(380) 898-5561
(380) 898-5563
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35051847
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2986050
—
OH
01
—
P00880716
RR MEDICARE
OH
Enumeration date
06/15/2006
Last updated
03/28/2019
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