Provider Demographics
NPI:1467847491
Name:PARKER, GOLDIE (DEM)
Entity Type:Individual
Prefix:
First Name:GOLDIE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 SUMMER PL
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-5908
Mailing Address - Country:US
Mailing Address - Phone:586-489-1608
Mailing Address - Fax:
Practice Address - Street 1:4317 SUMMER PL
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48316-5908
Practice Address - Country:US
Practice Address - Phone:586-489-1608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay