Provider Demographics
NPI:1639172661
Name:GOEL, ANNU R (DPM)
Entity Type:Individual
Prefix:
First Name:ANNU
Middle Name:R
Last Name:GOEL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4231
Mailing Address - Country:US
Mailing Address - Phone:419-479-5327
Mailing Address - Fax:419-479-5593
Practice Address - Street 1:6444 MONROE ST STE 1
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-1455
Practice Address - Country:US
Practice Address - Phone:567-420-2265
Practice Address - Fax:567-420-2263
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002768213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00032532OtherRAILROAD MEDICARE
OH0893850Medicaid
OH0724274Medicare PIN