Healthcare Provider Details

I. General information

NPI: 1093201733
Provider Name (Legal Business Name): NATHAN GELINAS MD, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 METROHEALTH DR OFC A107
CLEVELAND OH
44109
US

IV. Provider business mailing address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-4486
  • Fax: 216-778-5862
Mailing address:
  • Phone: 401-444-3985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD17677
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57.246250
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: