Individual
DR. IBRAHIMA GOUDIABY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
18599 LAKE SHORE BLVD, EUCLID, OH 44119-1093
(216) 383-5367
(216) 383-5309
Mailing address
18599 LAKE SHORE BLVD, EUCLID, OH 44119-1093
(216) 383-5367
(216) 383-5309
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34.012064
OH
207R00000X
Internal Medicine Physician
Primary
34012064
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0132241
—
OH
Enumeration date
01/30/2013
Last updated
12/30/2020
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