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NPI Code Detail

MEDICARE: DR. JAIME L GO MD

MEDICARE: DR. JAIME L GO MD
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
1208D00000XGeneral Practice Physician47885OH

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 : 1548257850
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAIME L GO MD
Provider Business Mailing Address
First Line : 1434 HOMESTEAD CREEK DR
Second Line :
City : BROADVIEW HTS
State : OH
Zip : 44147-2582
Country : US
Telephone Number : 440-884-2126
Fax Number :
Provider Business Practice Location Address
First Line : 6315 PEARL RD
Second Line : STE 206
City : PARMA HEIGHTS
State : OH
Zip : 44130-3082
Country : US
Telephone Number : 440-884-2126
Fax Number : 440-884-2127
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2005
Last Update Date : 09/11/2011

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Directions to “ DR. JAIME L GO MD” Practice Location

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