Provider Demographics
NPI:1811144678
Name:GAD, GEORGE FAYEZ LABIB YOUSSIEF (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:FAYEZ LABIB YOUSSIEF
Last Name:GAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:30 E APPLE ST STE 3300
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2939
Practice Address - Country:US
Practice Address - Phone:937-208-8394
Practice Address - Fax:937-641-2780
Is Sole Proprietor?:No
Enumeration Date:2008-08-24
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.124451207R00000X
IL125054418207R00000X
IN01073880A207R00000X
KY44822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100196840Medicaid
OH0237744Medicaid