Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 35-043394 | OH |
NPI | 1174610166 |
---|---|
Provider Name | Justin P Lavin |
First Address | Akron, OH 44307-2433 |
Second Address | Akron, OH 44307-2433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0395871 | (05) | OH |
C01696 | (02) |