Provider Demographics
NPI:1437387404
Name:GOLDSMITH, ARATHI RAJENDRAN (DO)
Entity Type:Individual
Prefix:
First Name:ARATHI
Middle Name:RAJENDRAN
Last Name:GOLDSMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 MASON ST
Mailing Address - Street 2:SUITE C200
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124
Mailing Address - Country:US
Mailing Address - Phone:313-274-5810
Mailing Address - Fax:313-274-1499
Practice Address - Street 1:835 MASON ST STE C200
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2231
Practice Address - Country:US
Practice Address - Phone:313-274-5810
Practice Address - Fax:313-274-1499
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAG018507207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP45390012Medicare PIN