Physician Compare National (NPI:1659335636)

HEALTHCARE PROVIDER: MITCHELL ROBERT GOLDSTEIN M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1659335636
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8527257922
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110118000215
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GOLDSTEIN
	Individual professional last name
Provider First Name	MITCHELL
	Individual professional first name
Provider Middle Name	ROBERT
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK MEDICAL COLLEGE
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	107 N EDDY ST
	Group Practice or individual's line 1 address
City	SOUTH BEND
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	466172920
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5742461036
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M