Provider Demographics
NPI:1114167970
Name:GO, CORAZON O (MD)
Entity Type:Individual
Prefix:DR
First Name:CORAZON
Middle Name:O
Last Name:GO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6171 EAST DARTMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131
Mailing Address - Country:US
Mailing Address - Phone:216-524-8915
Mailing Address - Fax:216-524-8915
Practice Address - Street 1:6171 EAST DARTMOOR AVE
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131
Practice Address - Country:US
Practice Address - Phone:216-524-8915
Practice Address - Fax:216-524-8915
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-040371208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics