MEDICARE: LAWRENCE M GOLDSTONE 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	208800000X	Urology Physician	036755	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	340008501	OTHER	GA	RAILROAD MEDICARE

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	:	1952405037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE M GOLDSTONE M.D.

Provider Business Mailing Address
First Line	:	1930 BRANNAN RD
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-4310
Country	:	US
Telephone Number	:	678-284-4040
Fax Number	:	678-284-4076

Provider Business Practice Location Address
First Line	:	5730 GLENRIDGE DR STE 200
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-5579
Country	:	US
Telephone Number	:	404-256-1844
Fax Number	:	404-256-3499

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

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	03/07/2023

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Directions to “ LAWRENCE M GOLDSTONE M.D.” Practice Location

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