Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD025607E | PA |
NPI | 1104813534 |
---|---|
Provider Name | Dr. Gregg Lincoln Goldstrohm |
First Address | Greensburg, PA 15601-2819 |
Second Address | Greensburg, PA 15601-2819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 01/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010560830001 | (05) | PA |
0784629000 | INDEPENDENCE BLUE SHIELD (01) | PA |
181242 | HIGHMARK BLUE SHIELD (01) | PA |
B40797 | (02) |