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General NPI Number Information
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NPI Number | 1568872828
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Entity Type | Individual
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Provider Name | URI GOLDBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 1 MEDICAL DR DEPT OF
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 240-232-6004
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 SIERRA DR STE 400
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City | GREENWOOD
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State | IN
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Zip | 46143-7241
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Country | US
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Telephone | 317-865-1462
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01080671A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 49727
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01080671A
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License Number State | IN
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