Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 35041620 | OH |
NPI | 1235132523 |
---|---|
Provider Name | Dr. Michael D Gunzenhaeuser |
First Address | Mansfield, OH 44906-4103 |
Second Address | Mansfield, OH 44906-4103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0359991 | (05) | OH |
E36723 | (02) | OH |