Provider Demographics
NPI:1598740987
Name:GOLDMAN AND MILLER CARDIOLOGY, P.C.
Entity Type:Organization
Organization Name:GOLDMAN AND MILLER CARDIOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-419-3400
Mailing Address - Street 1:30335 W 13 MILE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2262
Mailing Address - Country:US
Mailing Address - Phone:248-419-3400
Mailing Address - Fax:248-419-3410
Practice Address - Street 1:30335 W 13 MILE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2262
Practice Address - Country:US
Practice Address - Phone:248-419-3400
Practice Address - Fax:248-419-3410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-08
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOF360036061Medicare ID - Type Unspecified