Provider Demographics
NPI:1508610940
Name:JOVELLANOS, BIEN JINDRICH JOHANN BAUTISTA (MD)
Entity Type:Individual
Prefix:
First Name:BIEN JINDRICH JOHANN
Middle Name:BAUTISTA
Last Name:JOVELLANOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1044 BELMONTE AVENUE
Mailing Address - Street 2:ST. ELIZABETH YOUNGSTOWN, HOSPITAL INTERNAL MEDICINE
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504
Mailing Address - Country:US
Mailing Address - Phone:330-480-2616
Mailing Address - Fax:
Practice Address - Street 1:1044 BELMONTE AVENUE
Practice Address - Street 2:ST. ELIZABETH YOUNGSTOWN, HOSPITAL INTERNAL MEDICINE
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504
Practice Address - Country:US
Practice Address - Phone:330-480-2616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program