Goethals, Andrea Jo

Goethals, Andrea Jo is an individual health care provider with primary practice located at 8235 Holly Rd Suite 1, Grand Blanc MI 48439-2441. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Goethals, Andrea Jo can be contacted via phone (810) 694-9700.

Contact Information

Primary practice address
8235 Holly Rd Suite 1 Grand Blanc MI 48439-2441
Phone: (810) 694-9700
Fax: (810) 694-9940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 5101015223 Michigan

Profile Details

NPI number 1104956895
LBN Legal business name Goethals, Andrea Jo
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Apr 29th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104956895 NPPES
Michigan MEDICAID 114995665
Michigan Other 46149
Michigan Other 6U10108
Michigan Other 01007313
Michigan Other 0252511984
Michigan Other 0252511984
Michigan Other 0N89830006
Michigan Other 01007313
Michigan Other 382626202

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