Provider Demographics
NPI:1295950400
Name:BAZYLEWICZ, VALERIE LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:LYNNE
Last Name:BAZYLEWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:LYNNE
Other - Last Name:RICHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:106 KAYLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-7514
Mailing Address - Country:US
Mailing Address - Phone:937-444-4385
Mailing Address - Fax:937-712-3161
Practice Address - Street 1:106 KAYLEIGH DR
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-7514
Practice Address - Country:US
Practice Address - Phone:937-444-4385
Practice Address - Fax:937-712-3161
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine