Provider Demographics
NPI:1295786770
Name:GOBEZIE, REUBEN (MD)
Entity type:Individual
Prefix:
First Name:REUBEN
Middle Name:
Last Name:GOBEZIE
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 1:300 ALLEN BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6130
Mailing Address - Country:US
Mailing Address - Phone:844-746-8537
Mailing Address - Fax:216-313-9166
Practice Address - Street 1:300 ALLEN BRADLEY DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44124-6130
Practice Address - Country:US
Practice Address - Phone:844-746-8537
Practice Address - Fax:216-313-9166
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-088096207X00000X
MA220913207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2687061Medicaid
OH000001074862OtherANTHEM
OH7567690OtherAETNA
OH9210632OtherCIGNA
OHH084312OtherMEDICARE
OHH084311Medicare PIN
OH000000503695OtherANTHEM
OHH084311Medicare PIN
OH2687061Medicaid