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General NPI Number Information
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NPI Number | 1174729701
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Entity Type | Organization
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Legal Business Name | STUART M. GOLDMAN, DPM, PA
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 4000 OLD COURT RD STE 301
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City | PIKESVILLE
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State | MD
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Zip | 21208-6417
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Country | US
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Telephone | 410-235-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 OLD COURT RD STE 300
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City | PIKESVILLE
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State | MD
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Zip | 21208-2840
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Country | US
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Telephone | 410-235-2345
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Fax | 410-366-0897
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Authorized Official
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Title or Position | OWNER
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Name | DR. STUART MILES GOLDMAN
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Credential | DPM
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Telephone | 410-235-2345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 01444
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License Number State | MD
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