Individual
KEITH E. GOULET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2000 MEDICAL PKWY, SUITE 607, ANNAPOLIS, MD 21401-3742
(410) 266-1644
(410) 266-1642
Mailing address
2000 MEDICAL PKWY, SUITE 607, ANNAPOLIS, MD 21401-3742
(410) 266-1644
(410) 266-1642
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS 012903
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
H0070482
MD
207RP1001X
Pulmonary Disease Physician
H0070482
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GO1774721
HIGHMARK
PA
01
—
P00917232
MEDICARE RAILROAD
MD
Enumeration date
04/19/2006
Last updated
06/03/2011
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