Provider Demographics
NPI:1598767303
Name:GUNTSCH, DEBORAH (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:GUNTSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 MONROE ST UNIT 206
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2735
Mailing Address - Country:US
Mailing Address - Phone:419-473-6601
Mailing Address - Fax:419-479-6966
Practice Address - Street 1:5700 MONROE ST UNIT 206
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2735
Practice Address - Country:US
Practice Address - Phone:419-473-6601
Practice Address - Fax:419-479-6966
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35054540207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0634072OtherAETNA
OH01-0330004OtherUHC
OH000000141239OtherANTHEM
OH0691103Medicaid
OHGU0615136OtherMEDICARE
OH00314OtherPARAMOUNT
OH080130448OtherRRMC
OHGU0614136Medicare ID - Type Unspecified
OH000000141239OtherANTHEM