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NPI Code Detail

MEDICARE: DR. LAILA IBRAHIM GOMAA MD

MEDICARE: DR. LAILA IBRAHIM GOMAA MD
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
1207LP2900XPain Medicine (Anesthesiology) Physician35068963GIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000020807OTHERANTHEM
2311570738026OTHERCARESOURCE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356341911
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAILA IBRAHIM GOMAA MD
Provider Business Mailing Address
First Line : 8120 GARNET DR
Second Line :
City : DAYTON
State : OH
Zip : 45458-2141
Country : US
Telephone Number : 937-291-2511
Fax Number : 937-291-2523
Provider Business Practice Location Address
First Line : 8120 GARNET DR
Second Line :
City : DAYTON
State : OH
Zip : 45458-2141
Country : US
Telephone Number : 937-291-2511
Fax Number : 937-291-2523
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 04/09/2008

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