Provider Demographics
NPI:1295725208
Name:GOLD, SAMUEL J (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:J
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1120 WELLSTAR WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8929
Mailing Address - Country:US
Mailing Address - Phone:770-517-1900
Mailing Address - Fax:770-999-2506
Practice Address - Street 1:1120 WELLSTAR WAY STE 201
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30114
Practice Address - Country:US
Practice Address - Phone:770-517-1900
Practice Address - Fax:770-999-2506
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2019-10-03
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Provider Licenses
StateLicense IDTaxonomies
GA0444682080I0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080I0007XAllopathic & Osteopathic PhysiciansPediatricsClinical & Laboratory Immunology