Provider Demographics
NPI:1649279480
Name:GOLDSTEIN, DAVID MYRON (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MYRON
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2015 R ST NW
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1075
Mailing Address - Country:US
Mailing Address - Phone:202-232-5050
Mailing Address - Fax:202-232-6250
Practice Address - Street 1:2015 R ST NW
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1075
Practice Address - Country:US
Practice Address - Phone:202-232-5050
Practice Address - Fax:202-232-6250
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC110622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C89147Medicare UPIN