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NPI Code Detail

MEDICARE: SHUANG GAO MD, MS, MS, MSN, RD

MEDICARE: SHUANG GAO MD, MS, MS, MSN, RD
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
1133V00000XRegistered Dietitian164.007133IL
2390200000XStudent in an Organized Health Care Education/Training Program
3133V00000XRegistered Dietitian86068033IL

General Provider Information

NPI Number : 1326555798
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHUANG GAO MD, MS, MS, MSN, RD
Provider Business Mailing Address
First Line : 2115 LEITER RD
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-3600
Country : US
Telephone Number : 937-384-6800
Fax Number : 937-384-6938
Provider Business Practice Location Address
First Line : 2115 LEITER RD
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-3600
Country : US
Telephone Number : 937-384-6800
Fax Number : 937-384-6938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2018
Last Update Date : 03/25/2026

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