Individual
MRS. MARY CLARE REVOLINSKY DYKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
29325 HEALTH CAMPUS DR, STE 2, WESTLAKE, OH 44145-8201
(440) 835-6142
(440) 899-4383
Mailing address
26908 DETROIT RD, SUITE 301, WESTLAKE, OH 44145-2398
(440) 617-1823
(440) 617-0884
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35062525
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0903455
—
OH
01
—
P00308460
RR MEDICARE
OH
Enumeration date
10/19/2005
Last updated
07/16/2024
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