MEDICARE: MR. MICHAEL JOHN GOLDSMITH MSW

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	1041C0700X	Clinical Social Worker	Q1-0000365	DE

General Provider Information

NPI Number	:	1497977342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL JOHN GOLDSMITH MSW

Provider Business Mailing Address
First Line	:	36 RANKIN RD
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19711-4851
Country	:	US
Telephone Number	:	302-738-6309
Fax Number	:	302-651-5066

Provider Business Practice Location Address
First Line	:	1600 ROCKLAND RD
Second Line	:	A.I. DUPONT HOSPITAL FOR CHILDREN
City	:	WILMINGTON
State	:	DE
Zip	:	19803-0000
Country	:	US
Telephone Number	:	302-651-4556
Fax Number	:	302-651-5066

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/09/2007

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