Healthcare Provider Details

I. General information

NPI: 1942303334
Provider Name (Legal Business Name): MICHAEL LEWIS GOLDFEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL ROAD MARTHAS VINEYARD HOSPITAL
OAK BLUFF MA
02557
US

IV. Provider business mailing address

PO BOX 1236
OAK BLUFF MA
02557
US

V. Phone/Fax

Practice location:
  • Phone: 508-693-2400
  • Fax:
Mailing address:
  • Phone: 508-693-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number30292
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: