Healthcare Provider Details

I. General information

NPI: 1609969708
Provider Name (Legal Business Name): DAVID B.K. GOLDEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 10/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7939 HONEYGO BLVD SUITE 219
BALTIMORE MD
21236-4931
US

IV. Provider business mailing address

7939 HONEYGO BLVD SUITE 219
BALTIMORE MD
21236-4931
US

V. Phone/Fax

Practice location:
  • Phone: 410-931-0404
  • Fax: 410-931-0405
Mailing address:
  • Phone: 410-931-0404
  • Fax: 410-931-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberD0022913
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: