Provider Demographics
NPI:1386802668
Name:GOELLNER, EDUARDO (MD)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:GOELLNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RUA EDSON
Mailing Address - Street 2:86
Mailing Address - City:PASSO FUNDO
Mailing Address - State:RS
Mailing Address - Zip Code:99025150
Mailing Address - Country:BR
Mailing Address - Phone:55543-045-7918
Mailing Address - Fax:
Practice Address - Street 1:RUA EDSON
Practice Address - Street 2:86
Practice Address - City:PASSO FUNDO
Practice Address - State:RS
Practice Address - Zip Code:99025150
Practice Address - Country:BR
Practice Address - Phone:55543-045-7918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program