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General NPI Number Information
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NPI Number | 1558687632
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Entity Type | Organization
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Legal Business Name | JULIAN GO JR. MD PC
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 863 RIVERVIEW LN
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City | MARYSVILLE
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State | MI
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Zip | 48040-1507
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Country | US
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Telephone | 810-364-1202
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Fax |
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Provider Business Mailing Address
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Address Line | 863 RIVERVIEW LN
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City | MARYSVILLE
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State | MI
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Zip | 48040-1507
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Country | US
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Telephone | 810-364-1202
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIAN GO JR.
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Credential | M.D.
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Telephone | 810-364-1202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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