Healthcare Provider Details

I. General information

NPI: 1881885416
Provider Name (Legal Business Name): LAWRENCE N GOLDMAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 10/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS PARAGON MEDICAL BUILDING #208
ST THOMAS VI
00802-2615
US

IV. Provider business mailing address

PO BOX 9788
ST THOMAS VI
00801-2788
US

V. Phone/Fax

Practice location:
  • Phone: 340-714-1122
  • Fax: 340-715-4313
Mailing address:
  • Phone: 340-714-1122
  • Fax: 340-715-4313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberVI1128
License Number StateVI

VIII. Authorized Official

Name: DR. LAWRENCE NORMAN GOLDMAN
Title or Position: PRESIDENTT
Credential: MD
Phone: 340-714-1122