Provider Demographics
NPI:1417933094
Name:GASTALDO, JOSEPH M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:GASTALDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:614-268-9487
Mailing Address - Fax:614-262-7659
Practice Address - Street 1:3555 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 3020
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3912
Practice Address - Country:US
Practice Address - Phone:614-268-9487
Practice Address - Fax:614-262-7659
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2022-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.073497207RI0200X
OH35-07-3497207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2213278Medicaid
OHH32675Medicare UPIN
OH4064922Medicare PIN