Provider Demographics
NPI:1912008863
Name:GO-LIN, CARMEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:L
Last Name:GO-LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARMEN
Other - Middle Name:GO
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1608 STATE ROUTE 28
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8819
Mailing Address - Country:US
Mailing Address - Phone:513-722-1444
Mailing Address - Fax:513-722-1444
Practice Address - Street 1:1608 STATE ROUTE 28
Practice Address - Street 2:SUITE 1
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-8819
Practice Address - Country:US
Practice Address - Phone:513-722-1444
Practice Address - Fax:513-722-1444
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037844208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0369506Medicaid