Healthcare Provider Details

I. General information

NPI: 1639122492
Provider Name (Legal Business Name): TODD HARLEY GOLDBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 NEW HANOVER MEDICAL PARK DR
WILMINGTON NC
28403-5345
US

IV. Provider business mailing address

1200 OLD YORK RD
ABINGTON PA
19001-3788
US

V. Phone/Fax

Practice location:
  • Phone: 910-662-9300
  • Fax: 910-662-2401
Mailing address:
  • Phone: 215-481-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD034148E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number22946
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number2024-03180
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: