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General NPI Number Information
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NPI Number | 1629044946
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Entity Type | Individual
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Provider Name | HOWARD GOLDBERG MD
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 1603 WENTZVILLE PKWY
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City | WENTZVILLE
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State | MO
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Zip | 63385-3826
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Country | US
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Telephone | 636-332-8228
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Fax | 636-332-1190
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Provider Business Mailing Address
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Address Line | PO BOX 955534
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City | SAINT LOUIS
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State | MO
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Zip | 63195-5534
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Country | US
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Telephone |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 105258
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 105258
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License Number State | MO
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