Doctor Name: | DR. MARY J GOMBASH |
NPI Number: | 1528021201 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 35047714 |
Business Practice Address: | 4571 Westbourne Rd Toledo, OH - 436232015 |
Business Phone Number: | 4198411660 |
Business Fax Number: | 4198414103 |
Mailing Address: | 4571 Westbourne Rd, TOLEDO |
State: | OH |
Postal Code: | 436232015 |
Phone Number: | 4198411660 |
Fax Number: | 4198414103 |
NPI Enumeration Date: | 04/11/2006 |
NPI Last Update Date: | 07/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 35047714 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |