Healthcare Provider Details

I. General information

NPI: 1376527754
Provider Name (Legal Business Name): NEAL D GOLDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 01/21/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 GREENWAY RD STE A
BOONE NC
28607-4991
US

IV. Provider business mailing address

717 GREENWAY RD STE A
BOONE NC
28607-4991
US

V. Phone/Fax

Practice location:
  • Phone: 828-278-9230
  • Fax: 828-263-5686
Mailing address:
  • Phone: 828-278-9230
  • Fax: 828-263-5686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number9901411
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number9901411
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: