Provider Demographics
NPI:1558650176
Name:GOLDSTEIN, HAROLD JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:JONATHAN
Last Name:GOLDSTEIN
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 1:3901 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-3948
Mailing Address - Country:US
Mailing Address - Phone:715-907-0900
Mailing Address - Fax:715-803-6977
Practice Address - Street 1:3901 STEWART AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-3948
Practice Address - Country:US
Practice Address - Phone:715-907-0900
Practice Address - Fax:715-803-6977
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27071207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery