Provider Demographics
NPI:1003818998
Name:GOH, CHIT-GUAN (MD)
Entity Type:Individual
Prefix:
First Name:CHIT-GUAN
Middle Name:
Last Name:GOH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 BEAVER CREEK CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1745
Mailing Address - Country:US
Mailing Address - Phone:419-891-6221
Mailing Address - Fax:419-893-3394
Practice Address - Street 1:660 BEAVER CREEK CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1745
Practice Address - Country:US
Practice Address - Phone:419-891-6221
Practice Address - Fax:419-893-3394
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037416208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH12-01239OtherUHC
OH00013OtherPARAMOUNT
OH000000141242OtherANTHEM
OH0633993OtherAETNA
OH0292928Medicaid
OH0633993OtherAETNA
OHG14419Medicare UPIN