Organization
GATEWAY MEDICAL CLINICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAHEED ADEWUMI M.D. (OWNER)
(513) 326-2040
Entity
Organization
Contact information
Practice address
11497 SPRINGFIELD PIKE STE 5, SPRINGDALE, OH 45246-3551
(513) 326-2040
Mailing address
11497 SPRINGFIELD PIKE STE 5, SPRINGDALE, OH 45246-3551
(513) 326-2040
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
35-083640
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000371883
ANTHEM
OH
01
—
213311832006
MEDICAL MUTUAL
OH
05
—
2496375
—
OH
01
—
7101685
AETNA
OH
01
—
P00277464
MEDICARE RR
OH
Enumeration date
08/15/2007
Last updated
07/25/2013
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