Provider Demographics
NPI:1245526508
Name:PAVKOV, NATHANIEL (DO)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:PAVKOV
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 1:4040 EMBASSY PKWY STE 370
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-8372
Mailing Address - Country:US
Mailing Address - Phone:234-466-8633
Mailing Address - Fax:234-466-8502
Practice Address - Street 1:4040 EMBASSY PKWY STE 370
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-8372
Practice Address - Country:US
Practice Address - Phone:234-466-8633
Practice Address - Fax:234-466-8502
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8999207P00000X
OH34011322207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine