Individual
DR. TODD GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35-07-0691G
OH
207W00000X
Ophthalmology Physician
Primary
53432-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800753
UNITED HEALTH CARE
—
01
—
150957CR
PREFERRED CARE
—
01
—
180027332
PIQUA, RRMED
OH
01
—
180028986
TROY RRMED
OH
05
—
2014680
—
OH
01
—
33311121913800
ANTHEM BCBS
—
Enumeration date
07/21/2005
Last updated
11/22/2016
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