Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 34014676 | OH |
N | 208600000X | Surgeon | 34014676 | OH |
Y | 208200000X | Surgeon | 4301094772 | MI |
Y | 208600000X | Surgeon | 4301094772 | MI |
N | 2086S0102X | Surgical Critical Care | 34014676 | OH |
NPI | 1073741195 |
---|---|
Provider Name | Brent J Goslin |
First Address | Columbus, OH 43214-3983 |
Second Address | Columbus, OH 43214-3983 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 26/07/2021 |