Provider Demographics
NPI:1063467462
Name:GIRARDI, GERALD J (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:J
Last Name:GIRARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 BRITTANY LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-4074
Mailing Address - Country:US
Mailing Address - Phone:614-457-3141
Mailing Address - Fax:
Practice Address - Street 1:500 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8971
Practice Address - Country:US
Practice Address - Phone:614-898-4000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046395207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA81767Medicare UPIN
OHGI0561094Medicare ID - Type Unspecified