Provider Demographics
NPI:1942202197
Name:GOLDSCHMIDT, JOSEPH C (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:GOLDSCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:450 PARK WAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-4202
Mailing Address - Country:US
Mailing Address - Phone:484-422-8080
Mailing Address - Fax:484-422-8073
Practice Address - Street 1:3400 GARRETT RD
Practice Address - Street 2:SUITE A
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-2940
Practice Address - Country:US
Practice Address - Phone:610-626-0940
Practice Address - Fax:610-626-7140
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2010-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD037494E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011229840002Medicaid
PA115542K9LMedicare PIN
PA060035664Medicare PIN