Healthcare Provider Details

I. General information

NPI: 1780645267
Provider Name (Legal Business Name): RONALD STEPHEN GELB DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2006
Last Update Date: 03/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3731 WHIPPLE AVE NW
CANTON OH
44718-2933
US

IV. Provider business mailing address

3731 WHIPPLE AVE NW
CANTON OH
44718-2933
US

V. Phone/Fax

Practice location:
  • Phone: 330-493-3363
  • Fax: 330-493-3876
Mailing address:
  • Phone: 330-493-3363
  • Fax: 330-493-3876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36001550G
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number36001550G
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: