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General NPI Number Information
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NPI Number | 1497755177
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Entity Type | Individual
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Provider Name | STEPHEN B GOLDFARB D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6255 INKSTER RD SUITE 105
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City | GARDEN CITY
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State | MI
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Zip | 48135-2577
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Country | US
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Telephone | 734-522-0404
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Fax | 734-522-0835
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Provider Business Mailing Address
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Address Line | 6255 INKSTER RD SUITE 105
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City | GARDEN CITY
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State | MI
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Zip | 48135-2577
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Country | US
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Telephone | 734-522-0404
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Fax | 734-522-0835
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | SB006197
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License Number State | MI
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