Provider Demographics
NPI:1306820139
Name:GOLDIN, NORMAN R (MD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:R
Last Name:GOLDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 AKERS FARM RD
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-4863
Practice Address - Country:US
Practice Address - Phone:540-382-9405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301512718207RG0100X
VA0101034268207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
005818281OtherMEDICAID FIRST HEALTH
541870984OtherVA HEALTH NETWORK
110007207OtherMEDICARE TRAILBLAZERS
110175152OtherTRAVELERS RR MEDICARE
C05825OtherMEDICARE GROUP
209381OtherANTHEM OBICI
311323OtherMAMSI OPT CHOICE
394398OtherANTHEM HBV
25098OtherSENTARA OPTIMA
C13214OtherMEDICARE RR GROUP
VA005818281Medicaid
541870984006OtherCHAMPUS
541870984028OtherCIGNA
NC890605JMedicaid
VA110007207Medicare ID - Type Unspecified
311323OtherMAMSI OPT CHOICE