Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT-198142 | PA |
N | 111NI0900X | Internist | MT-198142 | PA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 63038 | AZ |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | MD-44625 | IA |
NPI | 1205124898 |
---|---|
Provider Name | Dr. Vishal Goyal |
First Address | Peoria, AZ 85381-4915 |
Second Address | Peoria, AZ 85381-4915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2011 |
Last Update Date | 25/01/2022 |