Individual
MS. ANDREA LESLIE GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1753 FULTON ST, ELKHART, IN 46514-1927
(574) 293-9448
(574) 293-9480
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2129
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01085704A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08333075
—
MS
05
—
213362795
—
AR
05
—
300050491
—
IN
Enumeration date
04/07/2016
Last updated
12/01/2025
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