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NPI Code Detail

MEDICARE: ELLEN J. L. GO M.D.

MEDICARE: ELLEN J. L. GO 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
12080P0216XPediatric Rheumatology Physician98700GA

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 : 1699059188
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN J. L. GO M.D.
Provider Business Mailing Address
First Line : 2174 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3102
Country : US
Telephone Number : 404-785-5437
Fax Number : 404-785-9096
Provider Business Practice Location Address
First Line : 2174 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3102
Country : US
Telephone Number : 404-785-5437
Fax Number : 404-785-9096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2011
Last Update Date : 03/05/2025

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