MEDICARE: DR. DAVID MYRON GOLDSTEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	11062	DC

General Provider Information

NPI Number	:	1649279480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MYRON GOLDSTEIN MD

Provider Business Mailing Address
First Line	:	2015 R ST NW
Second Line	:	2ND FLOOR
City	:	WASHINGTON
State	:	DC
Zip	:	20009-1075
Country	:	US
Telephone Number	:	202-232-5050
Fax Number	:	202-232-6250

Provider Business Practice Location Address
First Line	:	2015 R ST NW
Second Line	:	2ND FLOOR
City	:	WASHINGTON
State	:	DC
Zip	:	20009-1075
Country	:	US
Telephone Number	:	202-232-5050
Fax Number	:	202-232-6250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/08/2007

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