Provider Demographics
NPI:1871803767
Name:DOMINIC GOMES MD INC
Entity type:Organization
Organization Name:DOMINIC GOMES MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:CPC CPCH
Authorized Official - Phone:440-352-6132
Mailing Address - Street 1:1701 ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2508
Mailing Address - Country:US
Mailing Address - Phone:440-853-6692
Mailing Address - Fax:
Practice Address - Street 1:1701 ALLEN DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2508
Practice Address - Country:US
Practice Address - Phone:440-853-6692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty