Healthcare Provider Details

I. General information

NPI: 1720010531
Provider Name (Legal Business Name): VINCENT DOVICO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: VINCENT DOVICO M.D.

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 GENE DR
SEVEN HILLS OH
44131-5947
US

IV. Provider business mailing address

4301 GENE DR
SEVEN HILLS OH
44131-5947
US

V. Phone/Fax

Practice location:
  • Phone: 216-524-8228
  • Fax:
Mailing address:
  • Phone: 216-524-8228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35030614-D
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: