Provider Demographics
NPI:1346294683
Name:GUSZ, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:GUSZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3973 LOOMIS PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-1803
Mailing Address - Country:US
Mailing Address - Phone:330-296-8239
Mailing Address - Fax:330-296-6528
Practice Address - Street 1:3973 LOOMIS PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-1803
Practice Address - Country:US
Practice Address - Phone:330-296-8239
Practice Address - Fax:330-296-6528
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2013-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35069925G208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0280664Medicaid
OHGU0802251Medicare ID - Type Unspecified
OH0280664Medicaid