Healthcare Provider Details

I. General information

NPI: 1760076251
Provider Name (Legal Business Name): GOLDEN OAK MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 HENDERSONVILLE RD STE A
ASHEVILLE NC
28803-1916
US

IV. Provider business mailing address

1257 HENDERSONVILLE RD STE A
ASHEVILLE NC
28803-1916
US

V. Phone/Fax

Practice location:
  • Phone: 828-515-1254
  • Fax:
Mailing address:
  • Phone: 828-515-1254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: GOLNOSH SHARAFSALEH
Title or Position: OWNER
Credential: MD
Phone: 248-219-8950