Provider Demographics
NPI:1437896453
Name:GOYAL, KIRAN AJAYA
Entity Type:Individual
Prefix:
First Name:KIRAN
Middle Name:AJAYA
Last Name:GOYAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E KINGSLEY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-1139
Mailing Address - Country:US
Mailing Address - Phone:105-072-5021
Mailing Address - Fax:
Practice Address - Street 1:701 PRIOR HALL
Practice Address - Street 2:376 WEST 10TH AVENUE
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-293-8536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program