Provider Demographics
NPI:1093201733
Name:GELINAS, NATHAN (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:GELINAS
Suffix:
Gender:M
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-444-3985
Mailing Address - Fax:
Practice Address - Street 1:2500 METROHEALTH DR OFC A107
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109
Practice Address - Country:US
Practice Address - Phone:216-778-4486
Practice Address - Fax:216-778-5862
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD17677207R00000X
OH57.246250207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine