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General NPI Number Information
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NPI Number | 1295315356
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Entity Type | Individual
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Provider Name | DINORAH MARIE GOMEZ MD
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Gender | Female
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 10 PATEWOOD DR STE 150
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City | GREENVILLE
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State | SC
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Zip | 29615-6349
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Country | US
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Telephone | 864-454-5612
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Fax |
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Provider Business Mailing Address
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Address Line | 2055 KIMBALL AVE STE 101
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City | WATERLOO
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State | IA
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Zip | 50702-5047
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Country | US
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Telephone | 319-272-2112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 88143
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License Number State | SC
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