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Individual

DEXTER M GENSOLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
1600 E RIVERVIEW AVE, SUITE 107, NAPOLEON, OH 43545-9805
(419) 592-0800
(419) 592-0815
Mailing address
PO BOX 550, WAUSEON, OH 43567-0550
(419) 592-0800
(419) 592-0815

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-079093
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0151264
LABOR & INDUSTRIES PROV #
WA
01
080177294
TRAVELER MEDICARE
01
1090GE
REGENCE PROVIDER #
WA
05
8291643
WA
Enumeration date
08/29/2006
Last updated
06/30/2008
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