Provider Demographics
NPI:1649244666
Name:GORAN, NATALIE (DO)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:GORAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 FARR RD STE 2000
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-8797
Mailing Address - Country:US
Mailing Address - Phone:616-481-2601
Mailing Address - Fax:616-975-1870
Practice Address - Street 1:1450 FARR RD STE 2000
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-8797
Practice Address - Country:US
Practice Address - Phone:616-481-2601
Practice Address - Fax:616-975-1870
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23162160628207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00340207OtherRAILROAD MEDICARE
MIH73963Medicare UPIN
D16347030Medicare ID - Type Unspecified
MIP35450002Medicare PIN