Provider Demographics
NPI:1841653029
Name:GIFFEN, ZANE CRAIG (MD)
Entity type:Individual
Prefix:
First Name:ZANE
Middle Name:CRAIG
Last Name:GIFFEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3963 LOOMIS PKWY
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-1800
Mailing Address - Country:US
Mailing Address - Phone:330-443-2067
Mailing Address - Fax:
Practice Address - Street 1:3963 LOOMIS PKWY
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-1800
Practice Address - Country:US
Practice Address - Phone:330-443-2067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.142288208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program