Individual
DR. STEVEN MARK GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1352 E PARKDALE AVE, MANISTEE, MI 49660-9318
(231) 723-8363
(231) 398-2680
Mailing address
5959 LAWNDALE ST, LUDINGTON, MI 49431-2921
(231) 845-6261
(231) 843-9171
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1670
IA
152W00000X
Optometrist
Primary
4901004415
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4956961
—
MI
05
—
4956970
—
MI
05
—
4956980
—
MI
01
—
900E300160
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
01
—
900F410030
BCBS OF MICHIGAN
MI
01
—
P00349762
RAILROAD MEDICARE
MI
Enumeration date
02/14/2006
Last updated
06/14/2010
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