Healthcare Provider Details

I. General information

NPI: 1245266907
Provider Name (Legal Business Name): ELLIOT R GOLDSTEIN MD & JOEL R SCHULMAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 WISCONSIN AVE SUITE 645
CHEVY CHASE MD
20815-4404
US

IV. Provider business mailing address

6000 EXECUTIVE BLVD SUITE 300
ROCKVILLE MD
20852-3803
US

V. Phone/Fax

Practice location:
  • Phone: 301-656-4545
  • Fax:
Mailing address:
  • Phone: 301-468-8999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateMD

VIII. Authorized Official

Name: LORI WEISEL
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 240-207-2030