MEDICARE: STEVEN LEONARD HAZELCORN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	34007986	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740261452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN LEONARD HAZELCORN DO

Provider Business Mailing Address
First Line	:	1665 STONE CREEK LN
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-1057
Country	:	US
Telephone Number	:	330-425-0701
Fax Number	:

Provider Business Practice Location Address
First Line	:	1665 STONE CREEK LN
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-1057
Country	:	US
Telephone Number	:	330-425-0701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	10/29/2009

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