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General NPI Number Information
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NPI Number | 1295783223
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Entity Type | Individual
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Provider Name | ERIN BOOHER GOSHORN MD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 06/12/2015
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Provider Practice Location Address
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Address Line | 1674 CRANIUM DR STE 104
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City | ROCK HILL
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State | SC
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Zip | 29732-3583
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Country | US
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Telephone | 803-327-3937
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Fax | 803-792-0545
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Provider Business Mailing Address
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Address Line | 1674 CRANIUM DR STE 104
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City | ROCK HILL
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State | SC
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Zip | 29732-3583
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Country | US
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Telephone | 803-327-3937
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Fax | 803-792-0545
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35592
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 16005
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License Number State | SC
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