Provider Demographics
NPI:1700971819
Name:GOYAL, AMAR NATH (MD)
Entity type:Individual
Prefix:DR
First Name:AMAR
Middle Name:NATH
Last Name:GOYAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AMAR
Other - Middle Name:
Other - Last Name:GOYAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3900 SUNFOREST COURT
Mailing Address - Street 2:SUITE 132
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3074
Mailing Address - Country:US
Mailing Address - Phone:419-517-1351
Mailing Address - Fax:330-230-2865
Practice Address - Street 1:3900 SUNFOREST COURT
Practice Address - Street 2:SUITE 132
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3074
Practice Address - Country:US
Practice Address - Phone:419-490-7131
Practice Address - Fax:330-230-2865
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086768208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH60756Medicare UPIN