Individual
ROBERT I GOULART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
701 GROVE RD, 2ND FLOOR ANESTHESIA DEPT, GREENVILLE, SC 29605-5611
(864) 455-7111
Mailing address
255 ENTERPRISE BLVD, SUITE 250, GREENVILLE, SC 29615-6300
(864) 454-0888
(864) 454-1130
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN977
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20010908
SELECT HEALTH IND ID
SC
01
—
20031911
SELECT HEALTH GROUP
SC
01
—
430062057
MEDCARE RAILROAD
SC
05
—
AN0919
—
SC
Enumeration date
05/30/2006
Last updated
08/21/2008
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