Provider Demographics
NPI:1760424279
Name:ESSER-GLEASON, SYLVIA (DO)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:ESSER-GLEASON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2295 INFIRMARY RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-5737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 E PALMER RD
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2281
Practice Address - Country:US
Practice Address - Phone:937-592-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004085207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000026809OtherANTHEM
7755544OtherAETNA
341407259OtherNATIONWIDE
341407259OtherCIGNA
ES7250781OtherTRICARE
OH0631025Medicaid
87726OtherUHC
OH000000549608OtherANTHEM
341407259037OtherMEDICAL MUTUAL
930068283OtherRR MEDICARE
OH000000549608OtherANTHEM
341407259037OtherMEDICAL MUTUAL
341407259OtherNATIONWIDE