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General NPI Number Information
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NPI Number | 1255456299
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Entity Type | Organization
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Legal Business Name | EDWARD J. GOLDMAN, M.D.,P.A.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 25 CROSSROADS DRIVE SUITE 412
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5439
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Country | US
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Telephone | 443-394-6400
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Fax | 443-394-9850
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Provider Business Mailing Address
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Address Line | 25 CROSSROADS DR SUITE 412
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5439
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Country | US
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Telephone | 443-394-6400
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Fax | 443-394-9850
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | EDWARD JAY GOLDMAN
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Credential |
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Telephone | 443-394-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D76229
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D30288
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License Number State | MD
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