Individual
DR. KENNETH MICHAEL GOETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
5320 RIVER OAKS COURT, SYLVANIA, OH 43659-1875
(419) 882-1150
Mailing address
5320 RIVER OAKS COURT, SYLVANIA, OH 43659-1875
(419) 882-1150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
161403
NY
2083X0100X
Occupational Medicine Physician
25MA05782700
NJ
2083X0100X
Occupational Medicine Physician
Primary
35-071338
OH
Other
Enumeration date
12/31/2009
Last updated
12/31/2009
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