MEDICARE: NOELLE K GEHM OD

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
1	152W00000X	Optometrist	5116 T2015	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	74312	OTHER	OH	MOLINA
2	2201982	OTHER	OH	UNITED HEALTHCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	311584763027	OTHER	OH	CARESOURCE
5	2814245	OTHER	OH	AETNA
6	000000221564	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1861527939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOELLE K GEHM OD

Provider Business Mailing Address
First Line	:	10551 W NATIONAL RD
Second Line	:
City	:	NEW CARLISLE
State	:	OH
Zip	:	45344-9299
Country	:	US
Telephone Number	:	937-845-9444
Fax Number	:	937-845-1151

Provider Business Practice Location Address
First Line	:	10551 W NATIONAL RD
Second Line	:
City	:	NEW CARLISLE
State	:	OH
Zip	:	45344-9299
Country	:	US
Telephone Number	:	937-845-9444
Fax Number	:	937-845-1151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	01/29/2020

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Directions to “ NOELLE K GEHM OD” Practice Location

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