=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699719336
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA N GOMES M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2006
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6500 HOSPITAL DR
-----------------------------------------------------
City | HANNIBAL
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63401-6890
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 573-629-3462
-----------------------------------------------------
Fax | 573-629-3537
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6319 GAINSBOROUGH DR
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27612-6616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-526-2884
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | MD-54748
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | 2018040489
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------