Healthcare Provider Details

I. General information

NPI: 1780237933
Provider Name (Legal Business Name): GAMAL ISMAIL MASHALI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 CHERRY ST STE 2300
TOLEDO OH
43608-2675
US

IV. Provider business mailing address

2222 CHERRY ST STE 2300
TOLEDO OH
43608-2675
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-8025
  • Fax:
Mailing address:
  • Phone: 419-251-8025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number35.145871
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: