MEDICARE: DR. SEAN PATRICK GLEESON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	35077251	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164426920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN PATRICK GLEESON M.D.

Provider Business Mailing Address
First Line	:	700 CHILDRENS DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2664
Country	:	US
Telephone Number	:	614-722-6200
Fax Number	:	614-722-4966

Provider Business Practice Location Address
First Line	:	2599 S HAMILTON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4964
Country	:	US
Telephone Number	:	614-722-6200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	12/29/2025

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