Provider Demographics
NPI:1386823755
Name:GREGG L. GOLDSTROHM, MD PC
Entity Type:Organization
Organization Name:GREGG L. GOLDSTROHM, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTROHM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-832-6490
Mailing Address - Street 1:507 W NEWTON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2819
Mailing Address - Country:US
Mailing Address - Phone:724-832-6490
Mailing Address - Fax:724-834-8336
Practice Address - Street 1:507 W NEWTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2819
Practice Address - Country:US
Practice Address - Phone:724-832-6490
Practice Address - Fax:724-834-8336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016711530001Medicaid
1006386OtherGATEWAY HEALTH PLAN
104244OtherUPMC HEALTH PLAN
CA0732OtherRAILROAD MEDICARE
250003OtherHEALTH AMERICA
000000065367OtherUNISON HEALTH PLAN
PA661818OtherHIGHMARK BLUE SHIELD
PA661818Medicare PIN
250003OtherHEALTH AMERICA