Gomez, Manuel Antonio

Gomez, Manuel Antonio is an sole proprietor health care provider with primary practice located at 320 W Main St , White Sulphur Springs WV 24986-2414. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Cytopathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Gomez, Manuel Antonio can be contacted via phone (304) 647-6061.

Contact Information

Primary practice address
320 W Main St White Sulphur Springs WV 24986-2414
Phone: (304) 647-6061
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 10506 West Virginia
Allopathic & Osteopathic Physicians / Cytopathology 207ZC0500X 10506 West Virginia

Profile Details

NPI number 1841293636
LBN Legal business name Gomez, Manuel Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2005
Last updated Jan 19th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841293636 NPPES
Virginia MEDICAID 000650961
Virginia MEDICAID 0102000000

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