Individual
ERIC A GOULDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 MATTHEW ST, STE 302, MARIETTA, OH 45750-1644
(740) 568-5207
(740) 568-5297
Mailing address
8989 FILIZ LN, POWELL, OH 43065-9045
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35041792
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000650665
ANTHEM
OH
01
—
000000696918
ANTHEM
OH
05
—
0498288
—
OH
05
—
2005592000
—
WV
01
—
P00457495
RRMCR
OH
01
—
P01721803
RAILROAD MEDICARE - MMH
OH
Enumeration date
06/14/2005
Last updated
11/16/2017
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