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NPI Code Detail

MEDICARE: DR. SATOSHI GO D.M.D.

MEDICARE: DR. SATOSHI GO D.M.D.
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
1122300000XDentistDS036609PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497870919
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SATOSHI GO D.M.D.
Provider Business Mailing Address
First Line : 1701 E MOYAMENSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-1931
Country : US
Telephone Number : 215-462-4047
Fax Number : 208-498-4047
Provider Business Practice Location Address
First Line : 1701 E MOYAMENSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-1931
Country : US
Telephone Number : 215-462-4047
Fax Number : 208-498-4047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/09/2007

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