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NPI Code Detail

MEDICARE: DAVE GOLDMAN M.S.W.

MEDICARE: DAVE GOLDMAN M.S.W.
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
1104100000XSocial Worker6802065738MI

General Provider Information

NPI Number : 1942252655
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVE GOLDMAN M.S.W.
Provider Business Mailing Address
First Line : PO BOX 141214
Second Line :
City : DETROIT
State : MI
Zip : 48214-6214
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2051 W GRAND BLVD
Second Line :
City : DETROIT
State : MI
Zip : 48208-1105
Country : US
Telephone Number : 917-304-7032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 09/12/2007

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Directions to “ DAVE GOLDMAN M.S.W.” Practice Location

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