MEDICARE: MARIA R GOLDMAN CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	R086376	MD

General Provider Information

NPI Number	:	1417948654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA R GOLDMAN CRNP

Provider Business Mailing Address
First Line	:	200 MEMORIAL AVE
Second Line	:	CARROLL HOSPITAL CENTER
City	:	WESTMINSTER
State	:	MD
Zip	:	21157
Country	:	US
Telephone Number	:	410-871-6157
Fax Number	:	410-871-7199

Provider Business Practice Location Address
First Line	:	200 MEMORIAL AVE
Second Line	:	CARROLL HOSPITAL CENTER
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5726
Country	:	US
Telephone Number	:	410-871-6157
Fax Number	:	410-871-7199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	12/03/2009

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