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NPI Code Detail

MEDICARE: DR. EDWARD GOLDSTEIN MD

MEDICARE: DR. EDWARD GOLDSTEIN MD
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
1208D00000XGeneral Practice Physician161776NY
2208D00000XGeneral Practice Physician60812507WA
3208D00000XGeneral Practice PhysicianMD60812507WA

General Provider Information

NPI Number : 1689793093
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD GOLDSTEIN MD
Provider Business Mailing Address
First Line : 3629 S D ST
Second Line :
City : TACOMA
State : WA
Zip : 98418-6813
Country : US
Telephone Number : 253-649-1406
Fax Number :
Provider Business Practice Location Address
First Line : 3629 S D ST
Second Line :
City : TACOMA
State : WA
Zip : 98418-6813
Country : US
Telephone Number : 253-649-1406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 12/21/2022

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Directions to “ DR. EDWARD GOLDSTEIN MD” Practice Location

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