| Justin W Havemann Md Llc | |
|
19111 Detroit Rd Ste 103 Rocky River OH 44116-1740 | |
| (440) 356-9991 | |
| Not Available |
| Full Name | Justin W Havemann Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 19111 Detroit Rd Ste 103, Rocky River, Ohio |
| Authorized Official Name and Position | Justin W Havemann (MEMBER) |
| Authorized Official Contact | 4403569991 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Justin W Havemann Md Llc 180 Buckingham Rd Rocky River OH 44116-1621 Ph: (440) 523-9111 | Justin W Havemann Md Llc 19111 Detroit Rd Ste 103 Rocky River OH 44116-1740 Ph: (440) 356-9991 |
| NPI Number | 1215206370 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 03/21/2022 |
| Certification Date | 02/25/2022 |
| Medicare PECOS PAC ID | 3072909514 |
|---|---|
| Medicare Enrollment ID | O20220408000953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215206370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 35096698 (Ohio) | Primary |
| Provider Name | Justin W Havemann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528232741 PECOS PAC ID: 1153599931 Enrollment ID: I20110721000596 |
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