Healthcare Provider Details

I. General information

NPI: 1750474029
Provider Name (Legal Business Name): STEVEN M KALAVSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2006
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8423 MARKET ST STE 300 BOARDMAN MEDICAL PAVILION
BOARDMAN OH
44512-6778
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-1145
  • Fax: 330-729-1144
Mailing address:
  • Phone: 330-729-1145
  • Fax: 330-729-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number35-039434
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: