DR. DAVID DWIGHT GOLTRA JR. (NPI# 1477640647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477640647 |
| Entity Type | Individual |
| Full Name | DR. DAVID DWIGHT GOLTRA JR. |
| Credential | M.D. |
| Practice Address |
582 Lone Tree Drive 582 Long Point Rd Mt Pleasant SC 29464 |
| Mailing Address |
582 Lone Tree Drive 582 Long Point Road Florence SC 29501-0523 |
| Practice Telephone | 8433520674 |
| Practice Fax Number | 8439718832 |
| Mailing Telephone | 8433520674 |
| Mailing Fax Number | 8439718832 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2007-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
14764 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 147647 | 05 |
| Street Address |
582 LONE TREE DRIVE 582 LONG POINT RD |
| City | MT PLEASANT |
| State | SC |
| Zip Code | 29464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
| 1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
| 1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
| 1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
| 1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
| 1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
| 1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
| 1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
| 1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
| 1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
| Find all providers in zip 29464 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447316963 | Carolina Imaging Consultants P A | Radiology | 582 Long Point Road, Mt Pleasant, SC 29464 | 2006-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215991112 | Robert Leroy Waldron II | Radiology | 5 Richland Medical Park Rd, Columbia, SC 29203 | 2006-04-17 |
| 1649248519 | Aquilla Turk IIi | Radiology | 109 Doctors Dr, Greenville, SC 29605 | 2006-03-08 |
| 1710963624 | William L Woodard | Radiology | 43 Laurens St, Charleston, SC 29401-1561 | 2005-12-22 |
| 1851934186 | Imagecare Radiology Associates, LLC | Radiology | 710 Rabon Rd Ste 100, Columbia, SC 29203-8903 | 2019-10-18 |
| 1437566965 | Roshan Kumar Arjal | Radiology | 169 Ashley Ave Rm 202, Msc 333, Charleston, SC 29425-8905 | 2014-07-16 |
| 1447699970 | Andrew Fayette Barnes | Radiology | 316 Calhoun St, Charleston, SC 29401-1113 | 2013-06-18 |
| 1790028868 | Richard Christopher Leach | Radiology | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2013-03-27 |
| 1750642096 | Todd Michael Danziger | Radiology | 1210 W Faris Rd, Greenville, SC 29605 | 2012-06-04 |
| 1366762502 | Joseph Clayton Holladay IIi | Radiology | 1210 W Faris Rd, Greenville, SC 29605-4444 | 2010-06-10 |
| 1447493762 | Milad Yazdani | Radiology | 171 Ashley Ave, Charleston, SC 29425-8908 | 2009-04-16 |
| Find all providers with the same taxonomy | ||||
| City | MT PLEASANT |
| Zip Code | 29464 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.