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General NPI Number Information
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NPI Number | 1598159584
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Entity Type | Organization
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Legal Business Name | MARK C GOLDBERG MD LLC
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 27900 EUCLID AVE
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City | EUCLID
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State | OH
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Zip | 44132-3539
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Country | US
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Telephone | 216-261-0058
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Fax |
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Provider Business Mailing Address
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Address Line | 27900 EUCLID AVE
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City | EUCLID
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State | OH
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Zip | 44132-3539
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Country | US
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Telephone | 216-261-0058
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK C GOLDBERG
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Credential | MD
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Telephone | 216-261-0058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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