Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS006439E | PA |
N | 111NI0900X | Internist | OS006439E | PA |
N | 207RG0300X | Geriatric Medicine | OS006439E | PA |
NPI | 1033116843 |
---|---|
Provider Name | Michael R Goldner |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Bethlehem, PA 18017-7326 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 11/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E21930 | (02) | PA |