Healthcare Provider Details

I. General information

NPI: 1891897252
Provider Name (Legal Business Name): STEVEN JAMES GOLIAT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 12/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6571 BRECKSVILLE RD
INDEPENDENCE OH
44131-4848
US

IV. Provider business mailing address

4178 FAR-O-WAY LANE
RICHFIELD OH
44286
US

V. Phone/Fax

Practice location:
  • Phone: 216-524-8883
  • Fax: 216-524-2125
Mailing address:
  • Phone: 330-659-9327
  • Fax: 216-524-2125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.003346
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: