Provider Demographics
NPI:1750925269
Name:GOLDSBORO INTERNAL MEDICINE AND MED-SPA PLLC
Entity type:Organization
Organization Name:GOLDSBORO INTERNAL MEDICINE AND MED-SPA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RENU
Authorized Official - Middle Name:J
Authorized Official - Last Name:SETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-901-6223
Mailing Address - Street 1:1600 WAYNE MEMORIAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 WAYNE MEMORIAL DR STE C
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2201
Practice Address - Country:US
Practice Address - Phone:845-901-6223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty