Susan Mavis Goltz is a Specialist in Duluth, Minnesota. Susan Mavis Goltz practices all healthcare services and medical treatments related to Specialist. The NPI Number for Susan Mavis Goltz is 1811966500. The last update date is 2020-12-04.
Susan Mavis Goltz's current location address is 1000 E 1st St, Duluth, Minnesota. You can contact this provider via phone number 2187225629 and fax number 2187225148. The mailing address for Susan Mavis Goltz is 1000 E 1st St, Duluth, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Susan Mavis Goltz |
|---|---|
| Address | 1000 E 1st St, Duluth, Minnesota |
| Phone Number | 2187225629 |
| Fax Number | 2187225148 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1811966500 |
|---|---|
| Provider Enumeration Date | 2006-03-15 |
| Last Updated Date | 2020-12-04 |
Provider Mailing Address Detail
| Address | 1000 E 1st St |
|---|---|
| City | Duluth |
| State | Minnesota (MN) |
| Post Code | 558052297 |
| Phone Number | 2187225629 |
| Fax Number | 2187225148 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 33349 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 111079 | MN | UCARE | |
| 31754000 | WI | -- | |
| A005 | TRICARE | ||
| 2055782400 | MN | -- | |
| 725685 | MEDICA | ||
| 2F932SW | MN | BLUE CROSS BLUE SHIELD | |
| 346005 | PREFERRED ONE | ||
| HP22608 | MN | HEALTH PARTNERS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Susan Mavis Goltz by the Centers for Medicare & Medicaid Services?
The Susan Mavis Goltz has been issued the NPI (National Provider Identifier) 1811966500 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Susan Mavis Goltz located?
The Susan Mavis Goltz is located at 1000 E 1St St, Duluth, MN 558052297.
What is the Susan Mavis Goltz's specialty and taxonomy code?
The Susan Mavis Goltz's specialty is Specialist, and the corresponding taxonomy code is 174400000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1811966500 to Susan Mavis Goltz?
The Susan Mavis Goltz received its 1811966500 assignment from the Centers for Medicare & Medicaid Services on 2006-03-15.
When was the Susan Mavis Goltz's information last updated?
The Susan Mavis Goltz's information was last updated on 2020-12-04.