Individual
GEORGE SIVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1305 BOARDMAN POLAND RD, YOUNGSTOWN, OH 44514-1935
(330) 629-2300
(330) 629-2371
Mailing address
2601 MISSION POINT BLVD, SUITE 100, BEAVERCREEK, OH 45431-6600
(937) 912-4441
(937) 429-4236
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34004606S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0714794
—
OH
01
—
942460636209
CARESOURCE
OH
01
—
P00220368
MEDICARE RR-GA
OH
Enumeration date
06/01/2006
Last updated
11/29/2012
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