Provider Demographics
NPI:1285638742
Name:GOLDSTEIN, PHILIP D (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:D
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1511 GLEN DR
Mailing Address - Street 2:
Mailing Address - City:MAPLE GLEN
Mailing Address - State:PA
Mailing Address - Zip Code:19002-3106
Mailing Address - Country:US
Mailing Address - Phone:215-643-7761
Mailing Address - Fax:215-643-7762
Practice Address - Street 1:2705 DEKALB PIKE
Practice Address - Street 2:STE 205
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-1852
Practice Address - Country:US
Practice Address - Phone:610-277-6400
Practice Address - Fax:610-275-8861
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-028593-E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics