Basic Information
| Provider Information | |||||||||
| NPI: | 1073761565 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOEL | ||||||||
| FirstName: | PUNIT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., M.H.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 62 SEBASTIAN RD | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224055733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2036756090 | ||||||||
| FaxNumber: | 8324763990 | ||||||||
| Practice Location | |||||||||
| Address1: | 5801 BREMO RD | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232261907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042877270 | ||||||||
| FaxNumber: | 8042850726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2008 | ||||||||
| LastUpdateDate: | 12/10/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 0101250083 | VA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | C06778 | 01 | VA | GROUP PTAN | OTHER |