Provider Demographics
NPI:1538333505
Name:GOOCH, CHRISTOPHER MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:GOOCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CHURCH
Mailing Address - Street 2:
Mailing Address - City:RAYLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43943-9602
Mailing Address - Country:US
Mailing Address - Phone:740-859-5707
Mailing Address - Fax:304-234-8554
Practice Address - Street 1:2000 EOFF ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3823
Practice Address - Country:US
Practice Address - Phone:304-234-8177
Practice Address - Fax:304-234-8554
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-21
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2196207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine