Provider Demographics
NPI:1679505341
Name:GOODSTEIN, MICHAEL HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HOWARD
Last Name:GOODSTEIN
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:717-851-2613
Mailing Address - Fax:717-798-3677
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17405
Practice Address - Country:US
Practice Address - Phone:717-851-2613
Practice Address - Fax:717-798-3677
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042258E208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001415574Medicaid
PA097657OtherHIGHMARK BLUE SHIELD
PA1504467OtherGATEWAY-WMG
PA30266OtherJOHNS HOPKINS
PA340704OtherMAMSI-WMG
MD005625100Medicaid
PA01536702OtherCAPITAL BLUE CROSS-WMG
MD543141OtherCAREFIRST MD BCBS
PA39051OtherGEISINGER
PA5453115OtherAETNA
PA81766OtherUNISON-WMG
PA1118432OtherAMERIHEALTH MERCY
PA20101257OtherAMERIHEALTH MERCY-YHOBT
MD543141OtherCAREFIRST MD BCBS
PA097657OtherHIGHMARK BLUE SHIELD