Healthcare Provider Details

I. General information

NPI: 1518947084
Provider Name (Legal Business Name): MITCHELL GOLDSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 12/28/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST JOHNS HOPKINS
BALTIMORE MD
21205-2101
US

IV. Provider business mailing address

600 N WOLFE ST JOHNS HOPKINS
BALTIMORE MD
21205-2101
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-6143
  • Fax: 410-955-6143
Mailing address:
  • Phone: 410-955-6143
  • Fax: 410-955-6143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0053248
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: