Provider Demographics
NPI:1285638213
Name:GOLDMAN, EDWARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:STE 412
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5439
Mailing Address - Country:US
Mailing Address - Phone:443-394-6400
Mailing Address - Fax:443-394-9850
Practice Address - Street 1:25 CROSSROADS DR
Practice Address - Street 2:STE 412
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5439
Practice Address - Country:US
Practice Address - Phone:443-394-6400
Practice Address - Fax:443-394-9850
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
MDD30288207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT913OtherCAREFIRST FEDERAL
MD760010100Medicaid
MDKA47OtherCAREFIRST
MD760010100Medicaid
MDKA47OtherCAREFIRST