Provider Demographics
NPI:1306820139
Name:GOLDIN, NORMAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:R
Last Name:GOLDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5818 HARBOUR VIEW BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435
Mailing Address - Country:US
Mailing Address - Phone:757-483-6100
Mailing Address - Fax:757-483-2203
Practice Address - Street 1:5818 HARBOUR VIEW BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435
Practice Address - Country:US
Practice Address - Phone:757-483-6100
Practice Address - Fax:757-673-2203
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034268207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
110175152OtherTRAVELERS RR MEDICARE
25098OtherSENTARA OPTIMA
541870984006OtherCHAMPUS
394398OtherANTHEM HBV
005818281OtherMEDICAID FIRST HEALTH
110007207OtherMEDICARE TRAILBLAZERS
NC890605JMedicaid
C05825OtherMEDICARE GROUP
209381OtherANTHEM OBICI
C13214OtherMEDICARE RR GROUP
VA005818281Medicaid
541870984OtherVA HEALTH NETWORK
541870984028OtherCIGNA
311323OtherMAMSI OPT CHOICE
VA110007207Medicare ID - Type Unspecified
311323OtherMAMSI OPT CHOICE