Provider Demographics
NPI:1700085545
Name:GOEBEL, TERESA ELIZABETH (DO)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ELIZABETH
Last Name:GOEBEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:TERESA
Other - Middle Name:ELIZABETH
Other - Last Name:GULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3780 MEDINA RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-9311
Mailing Address - Country:US
Mailing Address - Phone:330-723-0759
Mailing Address - Fax:330-723-0780
Practice Address - Street 1:3780 MEDINA RD STE 140
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-9312
Practice Address - Country:US
Practice Address - Phone:330-723-0759
Practice Address - Fax:330-723-0780
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58002356207R00000X
OH34.009890207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology