Healthcare Provider Details

I. General information

NPI: 1225276579
Provider Name (Legal Business Name): RICHARD GAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2009
Last Update Date: 01/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10777 STATE ROUTE 682
THE PLAINS OH
45780-1328
US

IV. Provider business mailing address

10777 STATE ROUTE 682
THE PLAINS OH
45780-1328
US

V. Phone/Fax

Practice location:
  • Phone: 740-797-0506
  • Fax:
Mailing address:
  • Phone: 740-797-0506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35.053175
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: