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Individual
GWENDA FAYE GOGGIN
Active
Individual
GWENDA FAYE GOGGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840426
VA
363AM0700X
Medical Physician Assistant
0110840426
VA
363AM0700X
Medical Physician Assistant
PA078
MS
Other
Enumeration date
05/25/2006
Last updated
03/07/2023
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