Provider Demographics
NPI:1780682146
Name:SAWVEL, JOHN WALTER (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WALTER
Last Name:SAWVEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 COMMONS BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3820
Mailing Address - Country:US
Mailing Address - Phone:937-427-8912
Mailing Address - Fax:937-558-3067
Practice Address - Street 1:2510 COMMONS BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3820
Practice Address - Country:US
Practice Address - Phone:937-427-8912
Practice Address - Fax:937-558-3067
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007613S207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341935880028OtherCARESOURCE
OH2333246Medicaid
OH080186967OtherRR MEDICARE
OH000000323025OtherANTHEM
OH2889709OtherAETNA
OHH53343Medicare UPIN
OH000000323025OtherANTHEM