Provider Demographics
NPI:1306836416
Name:GOEL, ANIL K (MD)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:K
Last Name:GOEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1915 E 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-7244
Mailing Address - Country:US
Mailing Address - Phone:248-723-4777
Mailing Address - Fax:248-723-4776
Practice Address - Street 1:1915 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-7244
Practice Address - Country:US
Practice Address - Phone:248-723-4777
Practice Address - Fax:248-723-4776
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301067865207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G85001Medicare UPIN
M89900023Medicare ID - Type Unspecified