Individual
GARY A POTURALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 227-3361
(419) 226-9826
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35050177
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000317858
BCBS
OH
05
—
0559015
—
OH
01
—
P00060423
MEDICARE RR
OH
Enumeration date
05/24/2006
Last updated
05/16/2008
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