Organization
PAUL GOLDSHLACK DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL ALAN GOLDSHLACK DO (PRESIDENT)
(517) 484-4095
Entity
Organization
Contact information
Practice address
1200 E MICHIGAN AVE, SUITE 500, LANSING, MI 48912-1800
(517) 484-4095
Mailing address
PO BOX 492, OKEMOS, MI 48805-0492
(517) 484-4095
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
PG007284
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111869414
—
MI
01
—
1153311384
BLUE CROSS BLUE SHIELD MI
—
Enumeration date
08/22/2007
Last updated
08/22/2007
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