Healthcare Provider Details

I. General information

NPI: 1518994839
Provider Name (Legal Business Name): DONALD GOLDBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3545 OLENTANGY RIVER RD
COLUMBUS OH
43214-3907
US

IV. Provider business mailing address

858 BLUFF RIDGE DR
COLUMBUS OH
43235-1726
US

V. Phone/Fax

Practice location:
  • Phone: 614-846-2888
  • Fax: 614-846-2888
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: