Provider Demographics
NPI:1356087852
Name:LOUIS H. MEDVED MD
Entity Type:Organization
Organization Name:LOUIS H. MEDVED MD
Other - Org Name:LOUIS H. MEDVED MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:MEDVED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-227-3950
Mailing Address - Street 1:30 ERIE CANAL DR STE G
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4604
Mailing Address - Country:US
Mailing Address - Phone:585-227-3950
Mailing Address - Fax:585-730-7388
Practice Address - Street 1:30 ERIE CANAL DR STE G
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4604
Practice Address - Country:US
Practice Address - Phone:585-227-3950
Practice Address - Fax:585-730-7388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-07
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty