Individual
DR. MIKHAIL MIKHAILOVICH GORBOUNOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5057
(401) 606-1233
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5057
(401) 606-1233
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
A-177937
CA
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
A-177937
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD19925
RI
Other
Enumeration date
06/07/2018
Last updated
07/08/2024
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