Provider Demographics
NPI:1679777528
Name:GOYAL, KUSH KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:KUSH
Middle Name:KUMAR
Last Name:GOYAL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1730 W 25TH ST # 2C
Mailing Address - Street 2:CENTER FOR SPINE HEALTH- LUTHERAN HOSPITAL
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3108
Mailing Address - Country:US
Mailing Address - Phone:216-363-2410
Mailing Address - Fax:
Practice Address - Street 1:1730 W 25TH ST # 2C
Practice Address - Street 2:CENTER FOR SPINE HEALTH- LUTHERAN HOSPITAL
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3108
Practice Address - Country:US
Practice Address - Phone:216-363-2410
Practice Address - Fax:216-696-7395
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0926192081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine