Provider Demographics
NPI:1871039149
Name:TIMOTHY LEVAR DPM LLC
Entity Type:Organization
Organization Name:TIMOTHY LEVAR DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-585-2640
Mailing Address - Street 1:34600 CHARDON RD
Mailing Address - Street 2:SUITE 9A
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-8480
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34600 CHARDON RD
Practice Address - Street 2:SUITE 9A
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-8480
Practice Address - Country:US
Practice Address - Phone:440-585-2640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH003672332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site