Healthcare Provider Details

I. General information

NPI: 1801991435
Provider Name (Legal Business Name): DAVID JOHN GOLDEN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

694 MAIN ST
EAST GREENWICH RI
02818-3500
US

IV. Provider business mailing address

694 MAIN ST
EAST GREENWICH RI
02818-3500
US

V. Phone/Fax

Practice location:
  • Phone: 401-884-2821
  • Fax: 401-884-4350
Mailing address:
  • Phone: 401-884-2821
  • Fax: 401-884-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDPM00320
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: