Provider Demographics
NPI:1023351731
Name:GOLDSMITH, ALLISON MARGERY
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARGERY
Last Name:GOLDSMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 CIRCLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684
Mailing Address - Country:US
Mailing Address - Phone:231-932-4855
Mailing Address - Fax:
Practice Address - Street 1:224 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2700
Practice Address - Country:US
Practice Address - Phone:231-932-4855
Practice Address - Fax:231-935-0613
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301108633207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine