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Individual

DR. GREGORY PAUL KEZELE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3737 PARK EAST DR STE 109, BEACHWOOD, OH 44122-4329
(216) 464-7333
(216) 464-2696
Mailing address
3737 PARK EAST DR STE 109, BEACHWOOD, OH 44122-4329
(216) 464-7333
(216) 342-5462

Taxonomy

Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
35057308
OH
207Q00000X
Family Medicine Physician
35-057308
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000339410
ANTHEM
OH
05
2255705
OH
01
264200000
DEPT OF LABOR
OH
01
341425870042
MEDICAL MUTUAL OF OHIO
OH
01
6600162
RAILROAD
OH
01
80507
QUALCHOICE
OH
01
9379701
GROUP MEDICARE PTAN
OH
01
DO6570
GROUP MEDICARE RAILROAD PTAN
OH
01
H152671
MEDICARE INDIVIDUAL PTAN
OH
01
P01371818
MEDICARE RAILROAD INDIVIDUAL PTAN
OH
Enumeration date
03/24/2006
Last updated
10/30/2023
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