Individual
DR. BHASKAR GUNDABOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 W CENTRAL AVE, SUITE 100, TOLEDO, OH 43606-3834
(419) 537-5111
(419) 537-5131
Mailing address
2100 W CENTRAL AVE, SUITE 100, TOLEDO, OH 43606-3834
(419) 537-5111
(419) 537-5131
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
35088652
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000541140
ANTHEM
OH
05
—
2831243
—
OH
01
—
66501560001
MEDICAL MUTUAL
OH
01
—
6870
PARAMOUNT
OH
01
—
751132
BUCKEYE
OH
01
—
9567063
AETNA
OH
Enumeration date
05/18/2007
Last updated
11/03/2023
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