Provider Demographics
NPI:1003809088
Name:GOMBASH, ANDREW CARRINGTON (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CARRINGTON
Last Name:GOMBASH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:ANDREW
Other - Middle Name:C
Other - Last Name:GOMBASH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1600 E RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-9805
Mailing Address - Country:US
Mailing Address - Phone:419-592-1071
Mailing Address - Fax:419-592-1076
Practice Address - Street 1:1600 E RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-9805
Practice Address - Country:US
Practice Address - Phone:194-592-1071
Practice Address - Fax:194-592-1076
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004365G207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
311155352OtherEMERALD HEALTH
311155352OtherEV BENEFITS
311155352OtherCENTRAL BENEFITS
311155352OtherPPO NEXT
311155352OtherOHIO HEALTH CHOICE
OH000000260293OtherANTHEM
OH311155352OtherMEDIGOLD
311155352OtherGREAT WEST
311155352OtherAETNA
OH0146765Medicaid
311155352OtherNATIONWIDE INS.
0109967OtherUNITED HEALTHCARE
311155352001OtherTRICARE
311155352OtherCIGNA
311155352001OtherTRICARE
311155352OtherCIGNA