Individual
GAINNEOS R. GOLDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3020 HIGHWAY 124, SNELLVILLE, GA 30039-4614
(770) 978-1331
(770) 978-8580
Mailing address
3020 HIGHWAY 124, SNELLVILLE, GA 30039-4614
(770) 978-1331
(770) 978-8580
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
87599
GA
207R00000X
Internal Medicine Physician
M0735
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
87599
GA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD447980
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175370901
—
TX
05
—
175370902
—
TX
05
—
175370903
—
TX
01
—
8W8852
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/17/2006
Last updated
04/13/2023
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