Golladay, Eustace S
Golladay, Eustace S is an individual health care provider with primary practice located at 1500 East Medical Center Dr 3Rd Floor Mott Hospital Rm 3970, Ann Arbor MI 48109-0245. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Golladay, Eustace S can be contacted via phone (734) 764-4151.Contact Information
Primary practice address
1500 East Medical Center Dr 3Rd Floor Mott Hospital Rm 3970
Ann Arbor MI 48109-0245
Phone: (734) 764-4151
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 4301066654 | Michigan |
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | 4301066654 | Michigan |
Profile Details
| NPI number | 1164524492 |
|---|---|
| LBN Legal business name | Golladay, Eustace S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164524492 | NPPES |
| Michigan | MEDICAID | 3214332 |
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