Individual
GUSTAV R ELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
995 BEAVER GRADE ROAD, SUITE B, CORAOPOLIS, PA 15108-2766
(412) 264-9500
(412) 264-8999
Mailing address
995 BEAVER GRADE RD STE B2, CORAOPOLIS, PA 15108-2766
(412) 264-9500
(412) 264-8999
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
OS005112L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010799090027
—
PA
05
—
1079909
—
PA
01
—
1605U
BCBSNC
NC
05
—
2195413
—
OH
05
—
3810017484
—
WV
Enumeration date
04/03/2006
Last updated
10/06/2020
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