Provider Demographics
NPI:1750474433
Name:GOLDSTEIN, DAVID MEYER (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MEYER
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 1:2500 BROOKTREE ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9278
Mailing Address - Country:US
Mailing Address - Phone:724-934-7780
Mailing Address - Fax:724-934-7779
Practice Address - Street 1:2500 BROOKTREE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9278
Practice Address - Country:US
Practice Address - Phone:724-934-7780
Practice Address - Fax:724-934-7779
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033446E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1073629Medicaid
PA1073629Medicaid
PAG0151105Medicare ID - Type Unspecified