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General NPI Number Information
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NPI Number | 1336363936
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Entity Type | Organization
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Legal Business Name | VASCULAR INTERVENTIONS & VENOUS ASSOCIATES, LLC.
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 730 SOM CENTER RD GEORGIAN CENTER SUITE 170
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City | CLEVELAND
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State | OH
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Zip | 44143-2350
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Country | US
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Telephone | 440-442-9300
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Fax | 440-442-9308
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Provider Business Mailing Address
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Address Line | 730 SOM CENTER RD GEORGIAN CENTER SUITE 170
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City | CLEVELAND
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State | OH
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Zip | 44143-2350
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Country | US
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Telephone | 440-442-9300
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Fax | 440-442-9308
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. PATRICIA ANN DUGGAN
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Credential | MD
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Telephone | 440-442-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 35083562
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License Number State | OH
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