Healthcare Provider Details

I. General information

NPI: 1841466240
Provider Name (Legal Business Name): KANU SHRI GOYAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OLENTANGY RIVER RD STE 3200
COLUMBUS OH
43212-3167
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-2663
  • Fax: 614-293-2053
Mailing address:
  • Phone: 614-293-2663
  • Fax: 614-293-2053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number35123240
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: