Provider Demographics
NPI:1740243906
Name:GOLDSTEIN, DAVID STEWART (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:STEWART
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5421
Mailing Address - Country:US
Mailing Address - Phone:410-825-5454
Mailing Address - Fax:410-825-5811
Practice Address - Street 1:6535 N CHARLES ST
Practice Address - Street 2:SUITE 625
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-5826
Practice Address - Country:US
Practice Address - Phone:410-825-5454
Practice Address - Fax:410-825-5811
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2014-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD46270208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD272700500Medicaid
MD272700500Medicaid
MD914L358EMedicare PIN
MD731L574DMedicare PIN