Individual
MARY ELLEN GAEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
82 N BREIEL BLVD, MIDDLETOWN, OH 45042-3804
(513) 422-3119
(513) 420-1848
Mailing address
82 N BREIEL BLVD, MIDDLETOWN, OH 45042-3804
(513) 422-3119
(513) 420-1848
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
35044786
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0428424
—
OH
01
—
203767807
TAX ID
OH
Enumeration date
04/02/2006
Last updated
03/13/2026
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