Individual
DAWN NICHOL GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43825 MICHIGAN AVE, CANTON, MI 48188-2551
(734) 397-3088
Mailing address
8285 BISHOP RD, BRIGHTON, MI 48116-8308
(248) 882-0002
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704331894
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
892413341
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/06/2020
Last updated
10/06/2020
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