Provider Demographics
NPI:1134473168
Name:GEMMA, STEVEN MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARC
Last Name:GEMMA
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 1:4932 GALWAY DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-8410
Mailing Address - Country:US
Mailing Address - Phone:614-530-5789
Mailing Address - Fax:
Practice Address - Street 1:1479 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-8808
Practice Address - Country:US
Practice Address - Phone:937-642-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350587192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0882406Medicaid
OH30256Medicare UPIN