Provider Demographics
NPI:1740565837
Name:GOLD, PHILIP WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:WILLIAM
Last Name:GOLD
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 1:5415 W CEDAR LN
Mailing Address - Street 2:SUITE 204B
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1515
Mailing Address - Country:US
Mailing Address - Phone:301-605-5902
Mailing Address - Fax:301-405-1561
Practice Address - Street 1:5415 W CEDAR LN
Practice Address - Street 2:SUITE 204B
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1515
Practice Address - Country:US
Practice Address - Phone:301-605-5902
Practice Address - Fax:301-405-1561
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2021-08-24
Deactivation Date:2021-08-06
Deactivation Code:
Reactivation Date:2021-08-24
Provider Licenses
StateLicense IDTaxonomies
MDD178002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry