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General NPI Number Information
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NPI Number | 1902107972
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Entity Type | Individual
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Provider Name | MICHAEL GOLUB M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2010
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 1300 SUSSEX RD
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2519
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Country | US
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Telephone | 215-399-3248
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Fax | 215-545-4440
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Provider Business Mailing Address
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Address Line | 1300 SUSSEX RD
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2519
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Country | US
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Telephone | 215-399-3248
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Fax | 215-545-4440
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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 | MD031891E
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License Number State | PA
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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 | MD031891E
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License Number State | PA
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