Healthcare Provider Details

I. General information

NPI: 1932836855
Provider Name (Legal Business Name): GARVIN JIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 PORTAGE ST NW
NORTH CANTON OH
44720-2288
US

IV. Provider business mailing address

1413 PORTAGE ST NW
NORTH CANTON OH
44720-2288
US

V. Phone/Fax

Practice location:
  • Phone: 330-499-7591
  • Fax:
Mailing address:
  • Phone: 330-499-7591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.153736
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: