Doctor Name: | MR. DANIEL WALTER GEMBUS |
NPI Number: | 1255301941 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 35058947G |
Business Practice Address: | 195 Wadsworth Rd Wadsworth, OH - 442819504 |
Business Phone Number: | 3303341504 |
Business Fax Number: | 3303342918 |
Mailing Address: | 1238 Emerald Creek Dr, BROADVIEW HTS |
State: | OH |
Postal Code: | 441472575 |
Phone Number: | 4405460539 |
Fax Number: | 3306285572 |
NPI Enumeration Date: | 01/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 35058947G |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |