Healthcare Provider Details

I. General information

NPI: 1073638615
Provider Name (Legal Business Name): DAVID S GOLDSTEIN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DR # MSC-1620 BUILDING 10 ROOM 6N252
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

10 CENTER DRIVE MSC-1620 BUILDING 10 ROOM 6N252
BETHESDA MD
20892-1620
US

V. Phone/Fax

Practice location:
  • Phone: 301-496-2103
  • Fax:
Mailing address:
  • Phone: 301-496-2103
  • Fax: 301-402-0180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License NumberD0023433
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: