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General NPI Number Information
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NPI Number | 1831154079
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Entity Type | Individual
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Provider Name | KEITH E. GOULET D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 06/03/2011
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Provider Practice Location Address
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Address Line | 2000 MEDICAL PKWY SUITE 607
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3742
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Country | US
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Telephone | 410-266-1644
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Fax | 410-266-1642
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Provider Business Mailing Address
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Address Line | 2000 MEDICAL PKWY SUITE 607
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3742
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Country | US
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Telephone | 410-266-1644
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Fax | 410-266-1642
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS 012903
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | H0070482
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | H0070482
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License Number State | MD
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