Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301109030 | MI |
N | 111NI0900X | Internist | 4301109030 | MI |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 4301109030 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 039468 | CT |
N | 207RC0000X | Internist - Cardiovascular Disease | 4301109030 | MI |
NPI | 1073595633 |
---|---|
Provider Name | Daniel Robert Goldstein |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5856 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 02/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001394684 | (05) | CT |
G24883 | (02) |