Individual
GARY JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
667 EASTLAND AVE SE, WARREN, OH 44484-4503
(330) 841-4000
(330) 656-5901
Mailing address
5700 DARROW RD, SUITE 106, HUDSON, OH 44236-5021
(330) 656-5911
(330) 656-5901
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34-006110 J
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000162489
ANTHEM
OH
01
—
000000349348
ANTHEM
OH
01
—
000000381140
ANTHEM
OH
01
—
000000381220
ANTHEM
OH
01
—
000000381808
ANTHEM
OH
01
—
000000383091
ANTHEM
OH
01
—
000000385522
ANTHEM
OH
01
—
001671224-0001
PENNSYLVANIA MEDICAID
OH
01
—
001671224-0003
PENNSYLVANIA MEDICAID
OH
05
—
0216779
—
OH
Enumeration date
01/19/2006
Last updated
06/11/2008
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