Provider Demographics
NPI:1184618795
Name:GALVEZ, JAVIER V (MD)
Entity type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:V
Last Name:GALVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2460 FAIRMOUNT BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3171
Mailing Address - Country:US
Mailing Address - Phone:216-421-5105
Mailing Address - Fax:216-421-8999
Practice Address - Street 1:2460 FAIRMOUNT BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-3171
Practice Address - Country:US
Practice Address - Phone:216-421-5105
Practice Address - Fax:216-421-8999
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350388972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0452639Medicaid
OH34122435100OtherBUREAU OF WORKERS COMP
000000128755OtherANTHEM
000000128755OtherANTHEM
C01780Medicare UPIN