Provider Demographics
NPI:1104807445
Name:SAYVETZ, TOM A (MD)
Entity type:Individual
Prefix:MR
First Name:TOM
Middle Name:A
Last Name:SAYVETZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:25213-0808
Mailing Address - Country:US
Mailing Address - Phone:304-586-0771
Mailing Address - Fax:304-586-0799
Practice Address - Street 1:202 MAPLEWOOD AVE
Practice Address - Street 2:GREENBRIER VALLEY MEDICAL CENTER
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-1334
Practice Address - Country:US
Practice Address - Phone:304-647-4411
Practice Address - Fax:304-647-6064
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV17949207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5600562000Medicaid
WV5600562000Medicaid
E41717Medicare UPIN