Healthcare Provider Details

I. General information

NPI: 1902302698
Provider Name (Legal Business Name): DANIEL P. GOLDSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 HIGHLAND BLVD STE 5410
BOZEMAN MT
59715-6916
US

IV. Provider business mailing address

915 HIGHLAND BLVD
BOZEMAN MT
59715-6902
US

V. Phone/Fax

Practice location:
  • Phone: 406-414-2400
  • Fax: 406-414-3610
Mailing address:
  • Phone: 406-414-1720
  • Fax: 406-414-1071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number111717
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMED-PHYS-LIC-111717
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.138066
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: