Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 23334 | MN |
NPI | 1033113089 |
---|---|
Provider Name | Richard Elliot Golden |
First Address | Minneapolis, MN 55407 |
Second Address | Minneapolis, MN 55407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 19/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051062900 | (05) | MN |
A95765 | (02) |