Provider Demographics
NPI:1801312673
Name:CEPHAS, GERALD ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:ANTHONY
Last Name:CEPHAS
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 1:35 S SAINT CLAIR ST APT 402
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2167
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:240 W ELMWOOD DR STE 1000
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4248
Practice Address - Country:US
Practice Address - Phone:937-224-8200
Practice Address - Fax:937-224-3359
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012317222083P0901X, 208600000X, 261QR1100X
OH35.1321872083P0901X, 208600000X, 261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery