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General NPI Number Information
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NPI Number | 1891999488
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Entity Type | Individual
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Provider Name | GOCHA SALIASHVILI MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 3515 W MARKET ST STE 110
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City | GREENSBORO
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State | NC
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Zip | 27403-4439
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Country | US
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Telephone | 336-660-5220
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Fax | 336-660-5229
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone | 336-660-5220
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Fax | 336-660-5229
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 28859
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | BP1-0022068
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 795762
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2020-00629
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License Number State | NC
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