Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 9901411 | NC |
N | 207YS0123X | Facial Plastic Surgeon | 9901411 | NC |
NPI | 1376527754 |
---|---|
Provider Name | Neal D Goldman |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 20/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12332 | BCBS (01) | |
2005458000 | (05) | WV |
31887 | PARTNERS (01) | |
6502580 | (05) | VA |
7052087 | AETNA (01) | |
8912332 | (05) | NC |
91536 | MEDCOST (01) | |
G59780 | (02) | |
Q01411 | (05) | SC |