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General NPI Number Information
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NPI Number | 1396834222
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Entity Type | Organization
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Legal Business Name | JEFFREY GALVIN MD INC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 20455 LORAIN RD SUITE 104
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City | FAIRVIEW PARK
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State | OH
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Zip | 44126-3494
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Country | US
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Telephone | 440-333-3590
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Fax | 440-333-3625
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Provider Business Mailing Address
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Address Line | 20455 LORAIN RD SUITE 104
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City | FAIRVIEW PARK
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State | OH
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Zip | 44126-3494
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Country | US
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Telephone | 440-333-3590
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Fax | 440-333-3625
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY OWEN GALVIN
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Credential | MD
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Telephone | 440-333-3590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35062795
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License Number State | OH
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