Individual
MARY ANN LAVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
27059 CENTER RIDGE RD, WESTLAKE, OH 44145-4064
(440) 871-8933
(440) 899-9462
Mailing address
27059 CENTER RIDGE RD, WESTLAKE, OH 44145-4064
(440) 871-8933
(440) 899-9462
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35-04-1201
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374414
UNICARE
ID
01
—
000000656327
ANTHEM BLUE CROSS
OH
01
—
08-01054
UNITED HEALTHCARE
OH
05
—
3053574
—
OH
01
—
53491
QUALCHOICE
OH
01
—
5683020001
D M E R C/MEDICARE
OH
01
—
800519742052
CARESOURCE
OH
Enumeration date
07/03/2006
Last updated
07/14/2010
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