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General NPI Number Information
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NPI Number | 1801877964
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Entity Type | Individual
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Provider Name | BEVERLI S GOLDBERG MD
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Gender | Female
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 66 WADE AVE
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City | CATONSVILLE
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State | MD
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Zip | 21228-4614
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Country | US
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Telephone | 410-402-7178
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Fax |
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Provider Business Mailing Address
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Address Line | 2671 WYNFIELD RD
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City | WEST FRIENDSHIP
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State | MD
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Zip | 21794-9518
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Country | US
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Telephone | 410-442-4063
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D21968
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License Number State | MD
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