Individual
JOHN LEE GOAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2930 CHESTERFIELD AVE, CHARLESTON, WV 25304
(304) 343-9923
(304) 343-9925
Mailing address
2345 CHESTERFIELD AVE STE 302, CHARLESTON, WV 25304-1064
(681) 205-8610
(681) 205-8615
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
15533
WV
207RI0011X
Interventional Cardiology Physician
Primary
15533
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0086097000
—
WV
01
—
P01087430
RAILROAD MEDICARE
WV
Enumeration date
04/10/2006
Last updated
07/27/2018
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