MEDICARE: DR. AMIRA F GOHARA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZI0100X	Immunopathology Physician	35034334	OH
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	35034334	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831197458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIRA F GOHARA M.D.

Provider Business Mailing Address
First Line	:	3355 GLENDALE AVE FL 3
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2426
Country	:	US
Telephone Number	:	419-383-3470
Fax Number	:	419-383-6130

Provider Business Practice Location Address
First Line	:	3000 ARLINGTON AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2595
Country	:	US
Telephone Number	:	419-383-3470
Fax Number	:	419-383-6130

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	12/28/2017

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