Provider Demographics
NPI:1194748657
Name:GOMEZ, JOSE ENRIQUE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ENRIQUE
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:MD, PHD
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Other - First Name:
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Mailing Address - Street 1:ESSENTIA HEALTH DULUTH CLINIC MSS SSB-5
Mailing Address - Street 2:400 EAST THIRD STREET
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-786-3146
Mailing Address - Fax:218-786-7315
Practice Address - Street 1:400 E 3RD ST
Practice Address - Street 2:MCL2CRED
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-1951
Practice Address - Country:US
Practice Address - Phone:218-786-8319
Practice Address - Fax:218-722-8792
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN47415207R00000X, 207RP1001X, 208000000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208000000XAllopathic & Osteopathic PhysiciansPediatrics