Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | D23680 | MD |
NPI | 1851396311 |
---|---|
Provider Name | Dr. Seth Micah Goldberg |
First Address | Rockville, MD 20850 |
Second Address | Rockville, MD 20850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 27/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C62727 | (02) |