Provider Demographics
NPI:1932807351
Name:GEDEON, MICHAEL DENNIS JR (ACA, BC-HIS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DENNIS
Last Name:GEDEON
Suffix:JR
Gender:M
Credentials:ACA, BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32818 WALKER RD.
Mailing Address - Street 2:STE E-7
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012
Mailing Address - Country:US
Mailing Address - Phone:440-961-0075
Mailing Address - Fax:
Practice Address - Street 1:32818 WALKER RD.
Practice Address - Street 2:STE E-7
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-4401
Practice Address - Country:US
Practice Address - Phone:440-961-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02775237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter