Provider Demographics
NPI:1730783036
Name:GABOUR, MARIA (PHARMD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:GABOUR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4185 MORLEY DR
Mailing Address - Street 2:
Mailing Address - City:REMINDERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8168
Mailing Address - Country:US
Mailing Address - Phone:216-543-5779
Mailing Address - Fax:
Practice Address - Street 1:4185 MORLEY DR
Practice Address - Street 2:
Practice Address - City:REMINDERVILLE
Practice Address - State:OH
Practice Address - Zip Code:44202-8168
Practice Address - Country:US
Practice Address - Phone:216-543-5779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03440144OtherOHIO STATE BOARD OF PHARMACY