Individual
DR. JENNIFER L POPOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1133 MEDINA RD STE 100, MEDINA, OH 44256-5913
(330) 239-4350
(330) 239-4584
Mailing address
1133 MEDINA RD STE 100, MEDINA, OH 44256-5913
(330) 239-4350
(330) 239-4584
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
35076146 P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070015200
MEDICARE RAILROAD
OH
05
—
2190785
—
OH
01
—
9186053
MEDICARE GROUP LEGACY NUM
OH
01
—
9186055
MEDICARE GROUP LEGACY NUM
OH
Enumeration date
06/21/2005
Last updated
09/03/2014
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