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General NPI Number Information
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NPI Number | 1720281280
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Entity Type | Individual
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Provider Name | BENJAMIN DAVID GOLD D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | HENRY FORD WYANDOTTE HOSPITAL 2333 BIDDLE AVE
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City | WYANDOTTE
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State | MI
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Zip | 48192
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Country | US
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Telephone | 734-246-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 22231 LARCH ST
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City | WOODHAVEN
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State | MI
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Zip | 48183-5242
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | O-0923
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101016988
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License Number State | MI
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