MEDICARE: ADAM ANTHONY GOLAS M.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	35.143489	OH
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1114288792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM ANTHONY GOLAS M.D., M.P.H.

Provider Business Mailing Address
First Line	:	3170 KETTERING BLVD BLDG B3
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1924
Country	:	US
Telephone Number	:	937-991-3188
Fax Number	:	937-223-9811

Provider Business Practice Location Address
First Line	:	6611 CLYO RD STE F
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-2785
Country	:	US
Telephone Number	:	937-208-5300
Fax Number	:	937-208-2812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2012
Last Update Date	:	10/22/2021

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