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Individual

AJAY KUMAR GOYAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2011 S 25TH ST, SUITE 106, FORT PIERCE, FL 34947
(772) 468-7020
(772) 468-7698
Mailing address
2011 S 25TH ST, SUITE 106, FORT PIERCE, FL 34947
(772) 468-7020
(772) 468-7698

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME74489
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
254137800
FL
Enumeration date
08/31/2006
Last updated
09/18/2012
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