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NPI Code Detail

MEDICARE: CHRISTI M GOLDMAN PA-C

MEDICARE: CHRISTI M GOLDMAN PA-C
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
1363AM0700XMedical Physician Assistant10000576AIN
2363AM0700XMedical Physician AssistantPA675KY

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 : 1881682581
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTI M GOLDMAN PA-C
Provider Business Mailing Address
First Line : 6801 DIXIE HWY
Second Line : STE 130
City : LOUISVILLE
State : KY
Zip : 40258-3913
Country : US
Telephone Number : 502-585-4321
Fax Number : 502-587-8306
Provider Business Practice Location Address
First Line : 6420 DUTCHMANS PKWY STE 200
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-3373
Country : US
Telephone Number : 502-891-8300
Fax Number : 502-891-8338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 07/21/2022

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Directions to “ CHRISTI M GOLDMAN PA-C” Practice Location

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