MEDICARE: WILLIAM S. GOLDSTEIN, MD., PC

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	207W00000X	Ophthalmology Physician	4301056066	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	DH1713	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180509203	OTHER	MI	BCBS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649476581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM S. GOLDSTEIN, MD., PC

Provider Business Mailing Address
First Line	:	47670 VAN DYKE AVE
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48317-3302
Country	:	US
Telephone Number	:	586-323-2020
Fax Number	:	586-323-4145

Provider Business Practice Location Address
First Line	:	47670 VAN DYKE AVE
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48317-3302
Country	:	US
Telephone Number	:	586-323-2020
Fax Number	:	586-323-4145

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM S GOLDSTEIN
Credential	:	MD
Telephone Number	:	586-323-2020

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	06/13/2008

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