Healthcare Provider Details

I. General information

NPI: 1821213968
Provider Name (Legal Business Name): ANN GELKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3447 CORNELL PL
CINCINNATI OH
45220
US

IV. Provider business mailing address

3447 CORNELL PL
CINCINNATI OH
45220
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-6633
  • Fax: 513-751-7559
Mailing address:
  • Phone: 513-861-6633
  • Fax: 513-751-7559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOHIO 32656
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: