Healthcare Provider Details

I. General information

NPI: 1225072275
Provider Name (Legal Business Name): LYLE STEVEN GOLDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31500 TELEGRAPH RD STE 225
BINGHAM FARMS MI
48025-4315
US

IV. Provider business mailing address

31500 TELEGRAPH RD STE 225
BINGHAM FARMS MI
48025-4315
US

V. Phone/Fax

Practice location:
  • Phone: 248-552-0620
  • Fax:
Mailing address:
  • Phone: 248-552-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberLG053853
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: