Provider Demographics
NPI:1497741193
Name:GOLDBERG, HOWARD DAVID (MD)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:DAVID
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-4083
Mailing Address - Fax:717-812-2244
Practice Address - Street 1:35 MONUMENT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5074
Practice Address - Country:US
Practice Address - Phone:717-812-4083
Practice Address - Fax:717-812-2244
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4216242085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1465969OtherHIGHMARK BLUE SHIELD
PA235851OtherUNISON-WMG
PA5626667OtherAETNA
MD140004501Medicaid
PA001945759Medicaid
PA028354OtherJOHNS HOPKINS
PA20069113OtherAMERIHEALTH MERCY-WMG
PA50074888OtherCAPITAL BLUE CROSS-WMG
MD919374OtherCAREFIRST MD BCBS
PA1530452OtherGATEWAY-WMG
PA5626667OtherAETNA
PA50074888OtherCAPITAL BLUE CROSS-WMG
PA028354OtherJOHNS HOPKINS