Individual
HESHAM H EL GAMAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
960 W WOOSTER ST, SUITE 107, BOWLING GREEN, OH 43402-2644
(419) 373-7692
Mailing address
PO BOX 72369, CLEVELAND, OH 44192-0002
(419) 353-7069
(419) 353-7076
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35.084310
OH
207RP1001X
Pulmonary Disease Physician
Primary
35.084310
OH
207RS0012X
Sleep Medicine (Internal Medicine) Physician
35.084310
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A979680
BLUE SHIELD PPO PROVIDER NUMBER
CA
05
—
2492959
—
OH
01
—
7169581
AETNA PPO PROVIDER NUMBER
CA
01
—
A97968
MEDICAL LICENSE
CA
Enumeration date
11/08/2005
Last updated
06/17/2011
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