MEDICARE: DR. MARK A. 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	207RC0000X	Cardiovascular Disease Physician	D0036639	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932102357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK A. GOLDSTEIN MD

Provider Business Mailing Address
First Line	:	1838 GREENE TREE RD
Second Line	:	SUITE 150
City	:	BALTIMORE
State	:	MD
Zip	:	21208
Country	:	US
Telephone Number	:	410-602-9262
Fax Number	:	410-602-9276

Provider Business Practice Location Address
First Line	:	7505 OSLER DR
Second Line	:	STE 103
City	:	TOWSON
State	:	MD
Zip	:	21204-7737
Country	:	US
Telephone Number	:	410-583-1170
Fax Number	:	410-583-1267

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	08/31/2010

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Directions to “ DR. MARK A. GOLDSTEIN MD” Practice Location

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