Provider Demographics
NPI:1346509171
Name:GOLDMAN, JOSHUA J (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:J
Last Name:GOLDMAN
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 1:2040 W CHARLESTON BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2230
Mailing Address - Country:US
Mailing Address - Phone:702-671-2273
Mailing Address - Fax:
Practice Address - Street 1:1701 W CHARLESTON BLVD STE 190
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2312
Practice Address - Country:US
Practice Address - Phone:702-671-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18895208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery