Provider Demographics
NPI:1407821325
Name:MUTCHLER, GAIL E (MD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:E
Last Name:MUTCHLER
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 1:3545 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3907
Mailing Address - Country:US
Mailing Address - Phone:614-267-8585
Mailing Address - Fax:614-267-9793
Practice Address - Street 1:3545 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 201
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3907
Practice Address - Country:US
Practice Address - Phone:614-267-8585
Practice Address - Fax:614-267-9793
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-3979-M207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1897588-009OtherCIGNA
OH4880094OtherUNITED HEALTHCARE
OH000000014038OtherANTHEM
OH0554154Medicaid
OH0674462Medicaid
OH3111906786211OtherBC/BS
OH3111906786211OtherBC/BS
OHRI9924041Medicare ID - Type UnspecifiedMEDICARE
OH0554154Medicaid
OHA80483Medicare UPIN