Provider Demographics
NPI:1295965762
Name:GOLDIN, DMITRY Y (MD)
Entity type:Individual
Prefix:DR
First Name:DMITRY
Middle Name:Y
Last Name:GOLDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7704 MATAPEAKE BUSINESS DR STE 130
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-3049
Mailing Address - Country:US
Mailing Address - Phone:301-358-6070
Mailing Address - Fax:301-358-6111
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-5600
Practice Address - Fax:317-705-5047
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1291862085R0204X, 2085R0202X
IL0361385122085R0202X, 2085R0204X
MDD859942085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology