Healthcare Provider Details

I. General information

NPI: 1255350070
Provider Name (Legal Business Name): ROBERT N. GOLDSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

7590 AUBURN ROAD, SUITE 014 ATTN: MED STAFF
CONCORD TWP OH
44077-9176
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-8500
  • Fax:
Mailing address:
  • Phone: 440-354-1899
  • Fax: 440-354-1845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35-073154
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35-073154
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: