Provider Demographics
NPI:1265544969
Name:GORAN, DAVID ALAN (MD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALAN
Last Name:GORAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1150 E SHERMAN BLVD
Mailing Address - Street 2:STE 1500
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1871
Mailing Address - Country:US
Mailing Address - Phone:231-737-9378
Mailing Address - Fax:231-737-1023
Practice Address - Street 1:1150 E SHERMAN BLVD
Practice Address - Street 2:STE 1500
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1871
Practice Address - Country:US
Practice Address - Phone:231-737-9378
Practice Address - Fax:231-737-1023
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-11-13
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Provider Licenses
StateLicense IDTaxonomies
MI4301079878207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0004960267Medicaid
MII6277Medicare UPIN
MIP36810001Medicare PIN