MEDICARE: TIMOTHY LEVAR DPM LLC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	003672	OH

General Provider Information

NPI Number	:	1639595267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY LEVAR DPM LLC

Provider Business Mailing Address
First Line	:	34600 CHARDON RD
Second Line	:	SUITE 9
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-8480
Country	:	US
Telephone Number	:	440-585-2640
Fax Number	:	440-944-5278

Provider Business Practice Location Address
First Line	:	34600 CHARDON RD
Second Line	:	SUITE 9
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-8480
Country	:	US
Telephone Number	:	440-585-2640
Fax Number	:	440-944-5278

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MONICA JEAN NARDY
Credential	:
Telephone Number	:	440-585-2640

Provider Enumeration Date	:	03/06/2014
Last Update Date	:	04/15/2014

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