Walbroehl, Gordon S
Walbroehl, Gordon S is an individual health care provider with primary practice located at 4172 Indian Ripple Rd Ste. A, Beavercreek OH 45440-3285. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Walbroehl, Gordon S can be contacted via phone (937) 431-3779.Contact Information
Primary practice address
4172 Indian Ripple Rd Ste. A
Beavercreek OH 45440-3285
Phone: (937) 431-3779
Fax: (937) 431-3776
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35042049 | Ohio |
Profile Details
| NPI number | 1063494714 |
|---|---|
| LBN Legal business name | Walbroehl, Gordon S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 17th, 2005 |
| Last updated | Nov 16th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063494714 | NPPES |
| Ohio | MEDICAID | 0377391 |
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