Provider Demographics
NPI:1609895945
Name:DINGER, GARY WAYNE (DO)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:WAYNE
Last Name:DINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5334 MEADOW LANE COURT
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1469
Mailing Address - Country:US
Mailing Address - Phone:440-934-5454
Mailing Address - Fax:440-934-8999
Practice Address - Street 1:254 CLEVELAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1620
Practice Address - Country:US
Practice Address - Phone:440-934-2650
Practice Address - Fax:440-934-2651
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHG98117Medicare UPIN
OH0883346Medicare ID - Type Unspecified