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General NPI Number Information
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NPI Number | 1730290693
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Entity Type | Individual
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Provider Name | SHALINI GOSWAMI M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 1294 E MAIN ST
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City | PRATTVILLE
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State | AL
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Zip | 36066
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Country | US
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Telephone | 334-358-4052
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 242594
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City | MONTGOMERY
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State | AL
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Zip | 36124-2594
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Country | US
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Telephone | 334-462-0078
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD28536
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License Number State | AL
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