Individual
JAMES CHARLES GAIDELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, R.N.
Contact information
Practice address
13241 RAVENNA RD, CHARDON, OH 44024-9012
(216) 383-0100
(216) 383-6481
Mailing address
PO BOX 74751, CLEVELAND, OH 44194-0834
(216) 383-6480
(216) 383-6745
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00091401
MEDICARE RAILROAD
OH
Enumeration date
05/25/2006
Last updated
07/08/2007
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