Individual
DR. JENNIFER W GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 W STRUB RD, SUITE 330, SANDUSKY, OH 44870-5390
(419) 626-6700
(419) 626-6710
Mailing address
2500 W STRUB RD, SUITE 330, SANDUSKY, OH 44870-5390
(419) 626-6700
(419) 626-6710
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35069468
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000140612
ANTHEM BLUE CROSS
OH
01
—
070012084
RR MEDICARE
OH
05
—
2353215
—
OH
Enumeration date
07/07/2005
Last updated
06/26/2012
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