Individual
DR. DALE M GOUGHNOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
220 MAIN ST. STE 100, PORTAGE, PA 15946-1119
(814) 736-5000
(814) 736-9616
Mailing address
220 MAIN ST STE 100, PORTAGE, PA 15946-1119
(814) 736-5000
(814) 736-9616
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC004705L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01847551
—
PA
01
—
043195
UMWA
PA
01
—
304387
UPMC
PA
01
—
GO1304835
HIGHMARK
PW
Enumeration date
11/30/2006
Last updated
07/08/2007
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