Provider Demographics
NPI:1609216613
Name:GAW, EUSEBIO TIU (MD)
Entity Type:Individual
Prefix:MR
First Name:EUSEBIO
Middle Name:TIU
Last Name:GAW
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 1:3515 BANNING RD.
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239
Mailing Address - Country:US
Mailing Address - Phone:513-923-3153
Mailing Address - Fax:
Practice Address - Street 1:3515 BANNING RD.
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239
Practice Address - Country:US
Practice Address - Phone:513-923-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.032146208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery