Provider Demographics
NPI:1568569333
Name:GUNZLER, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:GUNZLER
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 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1611 S GREEN RD STE 204
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4123
Practice Address - Country:US
Practice Address - Phone:216-844-8685
Practice Address - Fax:216-844-5613
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.090685207T00000X, 2084N0400X
ORMD251712084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2786990Medicaid
OH752543OtherBUCKEYE MEDICAID
OH421796OtherWELLCARE MEDICAID
OH000000541320OtherANTHEM
OR269651Medicaid
OHP00428930OtherRAILROAD MEDICARE
OH000000229392OtherUNISON
OH7178687OtherAETNA
OH752543OtherBUCKEYE MEDICAID
OH000000541320OtherANTHEM