MEDICARE: DR. ALLAN L GOLDMAN M.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	207RR0500X	Rheumatology Physician	17900	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932162658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLAN L GOLDMAN M.D.

Provider Business Mailing Address
First Line	:	2801 W. KK RIVER PRKWY
Second Line	:	SUITE 375
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-3678
Country	:	US
Telephone Number	:	414-672-8550
Fax Number	:	414-672-8551

Provider Business Practice Location Address
First Line	:	2801 W KK RIVER PRKWY
Second Line	:	SUITE 375
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-3678
Country	:	US
Telephone Number	:	414-672-8550
Fax Number	:	414-672-8551

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	12/08/2021

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