Provider Demographics
NPI:1689611071
Name:DUELL, GERALYNN A (DO)
Entity Type:Individual
Prefix:
First Name:GERALYNN
Middle Name:A
Last Name:DUELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:GERALYNN
Other - Middle Name:A
Other - Last Name:DUELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:6350 CHEVIOT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-5108
Mailing Address - Country:US
Mailing Address - Phone:513-981-4300
Mailing Address - Fax:513-741-1416
Practice Address - Street 1:6350 CHEVIOT RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-5108
Practice Address - Country:US
Practice Address - Phone:513-981-4300
Practice Address - Fax:513-741-1416
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005708207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00919615OtherMEDICARE RR
OH0214968Medicaid
OHF52010Medicare UPIN
OH4234242Medicare PIN