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NPI Code Detail

MEDICARE: GARY WAYNE DINGER DO

MEDICARE: GARY WAYNE DINGER DO
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
1207Q00000XFamily Medicine Physician34007100OH

General Provider Information

NPI Number : 1609895945
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY WAYNE DINGER DO
Provider Business Mailing Address
First Line : 5334 MEADOW LANE COURT
Second Line :
City : SHEFFIELD VILLAGE
State : OH
Zip : 44035-1469
Country : US
Telephone Number : 440-934-5454
Fax Number : 440-934-8999
Provider Business Practice Location Address
First Line : 254 CLEVELAND AVE STE 101
Second Line :
City : AMHERST
State : OH
Zip : 44001-1620
Country : US
Telephone Number : 440-934-2650
Fax Number : 440-934-2651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 11/18/2020

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