Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 9272 | AZ |
NPI | 1003083502 |
---|---|
Provider Name | Dr. George David Goldberg |
First Address | Phoenix, AZ 85020-4725 |
Second Address | Phoenix, AZ 85020-4725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2008 |
Last Update Date | 14/05/2008 |