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NPI Code Detail

MEDICARE: DR. CARLOS E ZEVALLOS JR. D.O.

MEDICARE:  DR. CARLOS E ZEVALLOS JR. D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RR0500XRheumatology Physician34008130OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00337252OTHEROHMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619931433
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARLOS E ZEVALLOS JR. D.O.
Provider Business Mailing Address
First Line : 471 N CLEVELAND MASSILLON RD
Second Line :
City : AKRON
State : OH
Zip : 44333-2426
Country : US
Telephone Number : 330-668-4045
Fax Number : 330-668-2492
Provider Business Practice Location Address
First Line : 471 N CLEVELAND MASSILLON RD
Second Line :
City : AKRON
State : OH
Zip : 44333-2426
Country : US
Telephone Number : 330-668-4045
Fax Number : 330-668-2492
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2006
Last Update Date : 10/28/2010

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Directions to “ DR. CARLOS E ZEVALLOS JR. D.O.” Practice Location

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