MEDICARE: MR. ROBERT BRIAN GOLDBERG R.D.

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	133V00000X	Registered Dietitian	ND3401	FL

General Provider Information

NPI Number	:	1891760013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT BRIAN GOLDBERG R.D.

Provider Business Mailing Address
First Line	:	14370 MUSGROVE FARM CT
Second Line	:
City	:	GLENWOOD
State	:	MD
Zip	:	21738-9529
Country	:	US
Telephone Number	:	410-707-6963
Fax Number	:

Provider Business Practice Location Address
First Line	:	8901 ROCKVILLE PIKE
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20889-5001
Country	:	US
Telephone Number	:	240-731-1589
Fax Number	:

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	11/20/2023

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