Individual
DR. MICHAEL GENE GANGEL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2651 W MARKET ST, FAIRLAWN, OH 44333-4200
(330) 864-8008
(330) 864-1207
Mailing address
2651 W MARKET ST, FAIRLAWN, OH 44333-4200
(330) 864-8008
(330) 864-1207
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35-121958
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089610
—
OH
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
10/02/2008
Last updated
01/07/2016
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