Provider Demographics
NPI:1467787184
Name:GOEL, ANNURADHA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANNURADHA
Middle Name:
Last Name:GOEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNU
Other - Middle Name:
Other - Last Name:GOEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 191
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19723-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-4000
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:1602 JESSUP STREET
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4210
Practice Address - Country:US
Practice Address - Phone:302-576-5050
Practice Address - Fax:302-576-5065
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-064314-L208000000X
DEC10009500208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H7305ZMedicare UPIN