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NPI Code Detail

MEDICARE: DR. GARY A YOUNG MD

MEDICARE:  DR. GARY A YOUNG  MD
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
1207RC0000XCardiovascular Disease Physician35046446OH

Other Identifiers

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

General Provider Information

NPI Number : 1790757854
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY A YOUNG MD
Provider Business Mailing Address
First Line : 715 E WESTERN RESERVE RD
Second Line :
City : POLAND
State : OH
Zip : 44514-3358
Country : US
Telephone Number : 330-726-3204
Fax Number : 330-729-9316
Provider Business Practice Location Address
First Line : 715 E WESTERN RESERVE RD
Second Line :
City : POLAND
State : OH
Zip : 44514-3358
Country : US
Telephone Number : 330-726-3204
Fax Number : 330-729-9316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 02/13/2017

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Directions to “ DR. GARY A YOUNG MD” Practice Location

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