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General NPI Number Information
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NPI Number | 1912083759
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Entity Type | Organization
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Legal Business Name | WEST MICHIGAN OPHTHALMOLOGY, PC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 1150 E SHERMAN BLVD SUITE 1500
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City | MUSKEGON
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State | MI
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Zip | 49444-1871
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Country | US
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Telephone | 231-737-9378
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Fax | 231-737-1023
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Provider Business Mailing Address
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Address Line | 1150 E SHERMAN BLVD SUITE 1500
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City | MUSKEGON
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State | MI
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Zip | 49444-1871
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Country | US
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Telephone | 231-737-9378
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Fax | 231-737-1023
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID A GORAN
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Credential | MD
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Telephone | 231-737-9378
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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 | 4301079878
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License Number State | MI
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