Individual
DR. GARY GHISELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
DR.0042446
CO
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
DR.0042446
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107033250101
IHC
CO
01
—
4019320001
PALMETTO GBA
—
01
—
841519664006
RMHMO
CO
01
—
84151966413
PACIFICARE
CO
01
—
GH669216
BCBS
CO
Enumeration date
08/30/2005
Last updated
09/23/2022
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