Healthcare Provider Details

I. General information

NPI: 1346235728
Provider Name (Legal Business Name): CHRISTINE RENEE GAYNIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 01/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

582 N CABLE RD
LIMA OH
45805-2133
US

IV. Provider business mailing address

PO BOX 636930
CINCINNATI OH
45263-6930
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-2500
  • Fax: 419-996-2509
Mailing address:
  • Phone: 419-996-2650
  • Fax: 419-996-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35083566
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35083566
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: