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NPI Code Detail

MEDICARE: GARY R GIZE MD

MEDICARE: GARY R GIZE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology Physician01043454AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000083729OTHERINANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000693678OTHERINANTHEM
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255333167
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY R GIZE MD
Provider Business Mailing Address
First Line : 2514 E DUPONT RD STE 100
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1619
Country : US
Telephone Number : 260-484-8830
Fax Number : 260-483-1911
Provider Business Practice Location Address
First Line : 2514 E DUPONT RD STE 100
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1619
Country : US
Telephone Number : 260-484-8830
Fax Number : 260-483-1911
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 10/07/2022

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Directions to “ GARY R GIZE MD” Practice Location

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