Provider Demographics
NPI:1174537682
Name:GAEKE, RICHARD FRANCIS (MD FACP)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FRANCIS
Last Name:GAEKE
Suffix:
Gender:M
Credentials:MD FACP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:42 NORTH BREIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3804
Mailing Address - Country:US
Mailing Address - Phone:513-422-0024
Mailing Address - Fax:513-422-0232
Practice Address - Street 1:42 NORTH BREIEL BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3804
Practice Address - Country:US
Practice Address - Phone:513-422-0024
Practice Address - Fax:513-422-0232
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037374G207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9932791OtherMEDICARE GROUP
OH0428433Medicaid
OH0815621Medicaid
000000015648OtherANTHEM
641304OtherAETNA
000000015648OtherANTHEM
641304OtherAETNA