Mark E Davanzo, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

35051847 Issued in OH

Practice address

477 Cooper Rd
Suite 440
Westerville, OH 43081-8053

Phone

(380) 898-5561

Fax

(380) 898-5563

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1689618118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 COOPER RD",
            "address_2": "SUITE 440",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818053",
            "telephone_number": "380-898-5561",
            "fax_number": "380-898-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 COOPER RD",
            "address_2": "SUITE 440",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818053",
            "telephone_number": "380-898-5561",
            "fax_number": "380-898-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVANZO",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35051847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00880716",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2986050",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dasco HME, LLC
• Dasco HME, LLC
• Mollie Nicole Daubenmire
• Brooke Daugherty
• Brian Davanzo, M.D.
• Joni L Davenport
• David M. Ohle, O.D. LLC
• David R. Lawrence, D.O., LLC
• Patricia Helena David, MD, MSPH
• Ashley Davidson, M.S, ATC

• Surgery Physician in Westerville, OH
• Providers in Westerville, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.