| NPI | 1548406556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK E. DAVANZO Md/Owner Authorized Official 614-898-5561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35042997) |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2011-02-18 |