Provider Demographics
NPI:1235134321
Name:GURNEY, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:GURNEY
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 1:2726 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3506
Mailing Address - Country:US
Mailing Address - Phone:330-455-5011
Mailing Address - Fax:330-588-7127
Practice Address - Street 1:2726 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3506
Practice Address - Country:US
Practice Address - Phone:330-455-5011
Practice Address - Fax:330-588-7127
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.071051207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341773267COtherAULTCARE
OH000000138315OtherANTHEM BCBS #
OH0975888Medicaid
OH34177326700OtherBWC GROUP #
OH1487479005OtherCIGNA
OH341773267OtherCOMMERCIAL CARRIERS
OHCC9333OtherRR MEDICARE GROUP #
OH2900364OtherUNITED HEALTHCARE
OH4134169OtherAETNA
OH0304478Medicaid
OH100008806OtherRR MEDICARE PIN #
OH87920OtherQUALCHOICE
OH341773267OtherCOMMERCIAL CARRIERS
OH0304478Medicaid
OH341773267COtherAULTCARE