Provider Demographics
NPI:1750484606
Name:GOLDSTEIN, SUSAN T (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:T
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1156 PIEDMONT AVE NE
Mailing Address - Street 2:APT C5
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3774
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1156 PIEDMONT AVE NE
Practice Address - Street 2:APT C5
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3774
Practice Address - Country:US
Practice Address - Phone:404-607-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5622792207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease