Provider Demographics
NPI:1437159738
Name:GOLDSTEIN, WILLIAM SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30150 TELEGRAPH RD STE 271
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4521
Mailing Address - Country:US
Mailing Address - Phone:248-395-5166
Mailing Address - Fax:586-323-4145
Practice Address - Street 1:47670 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-3302
Practice Address - Country:US
Practice Address - Phone:586-323-2020
Practice Address - Fax:586-323-4145
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056066207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI180035148OtherRAILROAD MEDICARE
MI3453627 10Medicaid
MI3453627 10Medicaid
MI180035148OtherRAILROAD MEDICARE