Provider Demographics
NPI:1245266907
Name:ELLIOT R GOLDSTEIN MD & JOEL R SCHULMAN MD PA
Entity type:Organization
Organization Name:ELLIOT R GOLDSTEIN MD & JOEL R SCHULMAN MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-207-2030
Mailing Address - Street 1:6000 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3803
Mailing Address - Country:US
Mailing Address - Phone:301-468-8999
Mailing Address - Fax:
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 645
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-656-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207X00000X, 208800000X, 213E00000X, 207R00000X
207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD832407OtherMDIPA GROUP NUMBER
MD404178OtherCAREFIRST POS GROUP #
MD832407OtherOPTIMUM CHOICE GROUP #
MD832407OtherALLIANCE GROUP NUMBER
MDS204OtherBSMD GROUP NUMBER
MD832407OtherMAMSI GROUP NUMBER
MD9070OtherBSDC GROUP NUMBER
MDS204OtherBSMD GROUP NUMBER
MD832407OtherALLIANCE GROUP NUMBER
5549780002Medicare NSC