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Contact Information

LAURENCE W SPIVACK, DPM
9330 HIDDEN GLEN DR
MENTOR, OH44060
 Phone: 440-487-3947
 Fax: 513-858-7827
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for LAURENCE W SPIVACK · (Male)

NPI Number 1043215817
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 06/16/2005
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 36001535
  • OH Medicaid 0161999
  • OH Other 000000242733 ANTHEM
  • OH Other 016307 UNITED HEALTHCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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