Provider Demographics
NPI:1609379916
Name:GOULAS, MAX H (MD)
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:H
Last Name:GOULAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAX
Other - Middle Name:HUSFELT
Other - Last Name:GOULAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 PINCKNEY BLVD # 6216A
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6122
Mailing Address - Country:US
Mailing Address - Phone:281-757-7008
Mailing Address - Fax:
Practice Address - Street 1:1 PINCKNEY BLVD # 6216A
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6122
Practice Address - Country:US
Practice Address - Phone:281-757-7008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012678142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry