Provider Demographics
NPI:1295852135
Name:GOLSHANI, AMBER MARIE (ND)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:MARIE
Last Name:GOLSHANI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113A E DOVER ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3001
Mailing Address - Country:US
Mailing Address - Phone:410-822-7402
Mailing Address - Fax:410-822-7402
Practice Address - Street 1:113A E DOVER ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3001
Practice Address - Country:US
Practice Address - Phone:410-822-7402
Practice Address - Fax:410-822-7402
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099-0000172175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath