MEDICARE: SHARON NOBLE GOLDISH 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
1	208600000X	Surgery Physician	ME101229	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1891791380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON NOBLE GOLDISH M.D.

Provider Business Mailing Address
First Line	:	201 N CLYDE MORRIS BLVD
Second Line	:	STE 205
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-2724
Country	:	US
Telephone Number	:	386-425-3165
Fax Number	:	386-254-4285

Provider Business Practice Location Address
First Line	:	201 N CLYDE MORRIS BLVD
Second Line	:	STE 205
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-2724
Country	:	US
Telephone Number	:	386-425-3165
Fax Number	:	386-254-4285

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	02/11/2014

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