Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A89243 | CA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD 25471 | OR |
NPI | 1194817569 |
---|---|
Provider Name | Seth Leopold Goldsmith |
First Address | Clackamas, OR 97015-8970 |
Second Address | Clackamas, OR 97015-8970 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 04/02/2022 |