Provider Demographics
NPI:1760575658
Name:VALLEE, GERALD E (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:E
Last Name:VALLEE
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 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-441-1949
Mailing Address - Fax:740-446-5982
Practice Address - Street 1:1051 4TH AVENUE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1562
Practice Address - Country:US
Practice Address - Phone:740-446-5244
Practice Address - Fax:740-446-6300
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.028134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0408982Medicaid
WV0082615000Medicaid
WV0082615000Medicaid
OHH099160Medicare PIN
OHA71106Medicare UPIN