Healthcare Provider Details

I. General information

NPI: 1609379916
Provider Name (Legal Business Name): MAX HUSFELT GOULAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MAX H GOULAS MD

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PINCKNEY BLVD # 6216A
BEAUFORT SC
29902-6122
US

IV. Provider business mailing address

1 PINCKNEY BLVD # 6216A
BEAUFORT SC
29902-6122
US

V. Phone/Fax

Practice location:
  • Phone: 281-757-7008
  • Fax:
Mailing address:
  • Phone: 281-757-7008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101267814
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: