Provider Demographics
NPI:1346809282
Name:GOLDEN, ALLAN RANDELL (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:RANDELL
Last Name:GOLDEN
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 1:32255 NORTHWESTERN HWY STE 170
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1577
Mailing Address - Country:US
Mailing Address - Phone:248-932-1250
Mailing Address - Fax:
Practice Address - Street 1:32255 NORTHWESTERN HWY STE 170
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1577
Practice Address - Country:US
Practice Address - Phone:248-932-1250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351044830207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine