Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | OS4664 | FL |
NPI | 1093783086 |
---|---|
Provider Name | Dr. Marc David Golden |
First Address | Boca Raton, FL 33428-2231 |
Second Address | Delray Beach, FL 33446-3807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 02/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
055339500 | (05) | FL |
E22131 | (02) | FL |