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General NPI Number Information
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NPI Number | 1023931516
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Entity Type | Individual
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Provider Name | SHAWN WELLS GOLDMAN OM, RM, WMA
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Gender | Male
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Dates
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Enumeration Date | 08/01/2026
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Last Update Date | 08/01/2026
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Provider Practice Location Address
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Address Line | 4140 JONESBORO RD STE D3
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City | FOREST PARK
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State | GA
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Zip | 30297-1071
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Country | US
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Telephone | 678-783-4377
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 162299
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City | ATLANTA
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State | GA
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Zip | 30321-2299
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Country | US
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Telephone | 404-991-5703
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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