Basic Information
| Provider Information | |||||||||
| NPI: | 1083625255 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PINAULT | ||||||||
| FirstName: | GILLES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24701 EUCLID AVE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | EUCLID | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441171714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2163836616 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168447330 | ||||||||
| FaxNumber: | 2168443781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2006 | ||||||||
| LastUpdateDate: | 12/30/2010 | ||||||||
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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 | 2086S0102X | 35066311 | OH | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0129X | 35066311 | OH | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 207L00000X | 35066311 | OH | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LA0401X | 35066311 | OH | N | Allopathic & Osteopathic Physicians | Anesthesiology | Addiction Medicine | 207LC0200X | 35066311 | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207LH0002X | 35066311 | OH | N | Allopathic & Osteopathic Physicians | Anesthesiology | Hospice and Palliative Medicine | 207LP2900X | 35066311 | OH | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP3000X | 35066311 | OH | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology | 2086S0129X | 35-066311 P | OH | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | P00398038 | 01 | OH | RAILROAD MEDICARE | OTHER | 0583328 | 01 | OH | BCMH | OTHER | 2202793 | 01 | OH | AETNA | OTHER | 363915 | 01 | OH | WELLCARE MEDICAID | OTHER | 000000516073 | 01 | OH | ANTHEM | OTHER | 2268504 | 05 | OH | MEDICAID | 1083625255 | 01 | MI | MICHIGAN MEDICAID | OTHER | 744993 | 01 | OH | BUCKEYE MEDICAID | OTHER |