Provider Demographics
NPI:1609217934
Name:GAINES, SEAN (DO)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:GAINES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:30505 BAINBRIDGE ROAD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2287
Mailing Address - Country:US
Mailing Address - Phone:440-569-1153
Mailing Address - Fax:440-569-1553
Practice Address - Street 1:30505 BAINBRIDGE ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2287
Practice Address - Country:US
Practice Address - Phone:440-569-1153
Practice Address - Fax:440-569-1553
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2025-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34.011698207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0124793Medicaid