Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 01063106A | IN |
NPI | 1154476737 |
---|---|
Provider Name | Dr. Steven Edward Goldberg |
First Address | Louisville, KY 40241 |
Second Address | Charlestown, IN 47111-9553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 03/05/2010 |