Provider Demographics
NPI:1447438783
Name:DR MICHAEL GOINS
Entity type:Organization
Organization Name:DR MICHAEL GOINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:910-392-0270
Mailing Address - Street 1:5030 RANDALL PKWY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2829
Mailing Address - Country:US
Mailing Address - Phone:910-392-0270
Mailing Address - Fax:
Practice Address - Street 1:5030 RANDALL PKWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2829
Practice Address - Country:US
Practice Address - Phone:910-339-2027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1047152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909330Medicaid
NC0167420001Medicare NSC
NCT64967Medicare UPIN