Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 2009003012 | MO |
N | 207ND0101X | MOHS-Micrographic Surgeon | 2009003012 | MO |
N | 207NS0135X | Procedural Dermatology | 2009003012 | MO |
NPI | 1053421081 |
---|---|
Provider Name | Nicholas Joseph Golda |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65212-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/04/2019 |