# JOHN T. GOLDEN, M.D.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942404348
- **Authorized official:** DR. JOHN THEODORE GOLDEN M.D. (OWNER)
- **Authorized official phone:** (586) 776-0808

## Contact information

- **Practice address:** 25990 KELLY RD, SUITE 4, ROSEVILLE, MI 48066-4483
- **Practice address phone:** (586) 776-0808
- **Practice address fax:** (586) 771-0953
- **Mailing address:** 25990 KELLY RD, SUITE 4, ROSEVILLE, MI 48066-4483
- **Mailing address phone:** (586) 776-0808
- **Mailing address fax:** (586) 771-0953

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | JG052077 | MI | Yes |

## Other

- **Enumeration date:** 06/12/2007
- **Last updated:** 05/05/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2665188 | — | MI |