Individual
JUANITA R GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6045 BRIDGETOWN RD, CINCINNATI, OH 45248-3049
(513) 981-4105
(513) 347-4620
Mailing address
6045 BRIDGETOWN RD, CINCINNATI, OH 45248-3049
(513) 981-4105
(513) 347-4620
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-047464
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0495272
—
OH
01
—
P00919613
MEDICARE RR
OH
Enumeration date
07/04/2006
Last updated
05/07/2021
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