Provider Demographics
NPI:1255396198
Name:GOLDSTEIN, RICHARD A (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:857 S BECKFORD DR
Mailing Address - Street 2:STE E
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-3486
Mailing Address - Country:US
Mailing Address - Phone:252-492-5600
Mailing Address - Fax:252-492-5685
Practice Address - Street 1:857 S BECKFORD DR
Practice Address - Street 2:STE E
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-3486
Practice Address - Country:US
Practice Address - Phone:252-492-5600
Practice Address - Fax:252-492-5685
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2013-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC93-00478207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC040007095Other040007095
NC561844153OtherTRICARE/CHAMPUS
NC0000000230578OtherANTHEM BCBS
NC127333OtherWELLPATH SELECT, INC.
NC8936132Medicaid
NC192218205207OtherHUMANA CLAIMS OFFICE
NC36132OtherBCBS OF NORTH CAROLINA
NCD18908Medicare UPIN
NC040007095Other040007095