Basic Information
| Provider Information | |||||||||
| NPI: | 1013236819 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GENTHER | ||||||||
| FirstName: | DANE | ||||||||
| MiddleName: | JEFFERY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9500 EUCLID AVE | ||||||||
| Address2: | A71 | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164453729 | ||||||||
| FaxNumber: | 2164459409 | ||||||||
| Practice Location | |||||||||
| Address1: | 9500 EUCLID AVE | ||||||||
| Address2: | A71 | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164453729 | ||||||||
| FaxNumber: | 2164459409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2010 | ||||||||
| LastUpdateDate: | 07/03/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | MD181943 | OR | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | D74754 | MD | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 35.133967 | OH | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.