Provider Demographics
NPI:1558687632
Name:JULIAN GO JR. MD PC
Entity Type:Organization
Organization Name:JULIAN GO JR. MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:810-364-1202
Mailing Address - Street 1:863 RIVERVIEW LN
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-1507
Mailing Address - Country:US
Mailing Address - Phone:810-364-1202
Mailing Address - Fax:
Practice Address - Street 1:863 RIVERVIEW LN
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:MI
Practice Address - Zip Code:48040-1507
Practice Address - Country:US
Practice Address - Phone:810-364-1202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty