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NPI Code Detail

MEDICARE: MR. RENATO C. GAHOL M.D.

MEDICARE:  MR. RENATO C. GAHOL  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
12084P0800XPsychiatry Physician054097GA
22084P0800XPsychiatry PhysicianM-1410GU

General Provider Information

NPI Number : 1508862269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RENATO C. GAHOL M.D.
Provider Business Mailing Address
First Line : 790 GOV. CARLOS G. CAMACHO RD.
Second Line :
City : TAMUNING
State : GU
Zip : 96913
Country : US
Telephone Number : 671-647-5413
Fax Number : 671-649-6948
Provider Business Practice Location Address
First Line : 790 GOV. CARLOS G. CAMACHO RD.
Second Line :
City : TAMUNING
State : GU
Zip : 96913
Country : US
Telephone Number : 671-647-5413
Fax Number : 671-649-6948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 07/24/2013

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Directions to “ MR. RENATO C. GAHOL M.D.” Practice Location

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