Provider Demographics
NPI:1376627174
Name:GOLDBERG, MARSHALL FRANKLIN (MD)
Entity Type:Individual
Prefix:
First Name:MARSHALL
Middle Name:FRANKLIN
Last Name:GOLDBERG
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 1:4388 TEA ROSE CT
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-9427
Mailing Address - Country:US
Mailing Address - Phone:360-675-5888
Mailing Address - Fax:
Practice Address - Street 1:4388 TEA ROSE CT
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-9427
Practice Address - Country:US
Practice Address - Phone:360-675-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044793207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology