Provider Demographics
NPI:1265482137
Name:GOLDSTEIN, MERYL LEVYA (MD PHD)
Entity Type:Individual
Prefix:
First Name:MERYL
Middle Name:LEVYA
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:MERYL
Other - Middle Name:LEE
Other - Last Name:TILLOTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 419
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0419
Mailing Address - Country:US
Mailing Address - Phone:828-366-1150
Mailing Address - Fax:828-586-8209
Practice Address - Street 1:509 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4601
Practice Address - Country:US
Practice Address - Phone:828-253-0762
Practice Address - Fax:828-254-4892
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09900057207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891214EMedicaid
NC1214EOtherBCBS NC
NC220029036OtherRAILROAD MEDICARE
G49127Medicare UPIN
NC2275205BMedicare PIN