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General NPI Number Information
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NPI Number | 1720088859
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Entity Type | Individual
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Provider Name | MICHAEL R GEDEON MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 150 SPRINGSIDE DR STE 320C
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City | FAIRLAWN
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State | OH
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Zip | 44333-2486
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Country | US
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Telephone | 330-376-1071
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 MASSILLON RD STE 300
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City | UNIONTOWN
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State | OH
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Zip | 44685-7854
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Country | US
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Telephone | 330-376-1071
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Fax | 330-376-0130
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35055402
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License Number State | OH
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