MEDICARE: DR. DEVON N GOLDING MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	R2F38	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00306956	OTHER	MO	RAILROAD MEDICARE
3	080154726	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942288006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEVON N GOLDING MD

Provider Business Mailing Address
First Line	:	3535 S JEFFERSON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-3930
Country	:	US
Telephone Number	:	314-664-4808
Fax Number	:	314-772-0600

Provider Business Practice Location Address
First Line	:	3535 S JEFFERSON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-3930
Country	:	US
Telephone Number	:	314-664-4808
Fax Number	:	314-772-0600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2006
Last Update Date	:	10/04/2012

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Directions to “ DR. DEVON N GOLDING MD” Practice Location

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