Provider Demographics
NPI:1811391006
Name:GOLDSMITH, PATRICK EDWARD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:EDWARD
Last Name:GOLDSMITH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL STAFF SERVICES 1775 FORRESTAL DRIVE BLVD 41
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23551-0001
Mailing Address - Country:US
Mailing Address - Phone:910-581-0065
Mailing Address - Fax:
Practice Address - Street 1:MARINE STAFF SERVICES 1775 FORRESTAL DRIVE BLDG 41
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23551-0001
Practice Address - Country:US
Practice Address - Phone:910-581-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-16
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1208097363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant