Provider Demographics
NPI:1124257381
Name:GOMEZ, ELIEZER ARODY (MD)
Entity type:Individual
Prefix:
First Name:ELIEZER
Middle Name:ARODY
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20001 W 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-3403
Mailing Address - Country:US
Mailing Address - Phone:313-794-5111
Mailing Address - Fax:313-794-5153
Practice Address - Street 1:20001 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3403
Practice Address - Country:US
Practice Address - Phone:313-794-5111
Practice Address - Fax:313-794-5153
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301094740207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine