Provider Demographics
NPI:1730169822
Name:GELESH, GARY C (DO)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:C
Last Name:GELESH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2679
Mailing Address - Country:US
Mailing Address - Phone:330-666-4820
Mailing Address - Fax:330-666-4820
Practice Address - Street 1:1106 COLEGATE DR
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1323
Practice Address - Country:US
Practice Address - Phone:740-568-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006231207P00000X
LA000003207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1621412Medicaid
WV3810009945Medicaid
OH0570501Medicaid
LA1621412Medicaid
OH0570501Medicaid