Provider Demographics
NPI:1932513751
Name:GOLDFARB, MIKHAIL (DO)
Entity Type:Individual
Prefix:
First Name:MIKHAIL
Middle Name:
Last Name:GOLDFARB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 MERCY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2353
Mailing Address - Country:US
Mailing Address - Phone:402-280-4438
Mailing Address - Fax:
Practice Address - Street 1:7710 MERCY RD STE 202
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2353
Practice Address - Country:US
Practice Address - Phone:402-280-4438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2616207RC0200X
IL036148686208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine