Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 35086135 | OH |
NPI | 1093719965 |
---|---|
Provider Name | Dr. Jeffrey P Gold |
First Address | Toledo, OH 43614-2426 |
Second Address | Toledo, OH 43614-2595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 25/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C10165 | (02) |