Provider Demographics
NPI:1750556791
Name:RICHARD A. GOLDSTEIN, M.D.
Entity type:Organization
Organization Name:RICHARD A. GOLDSTEIN, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-492-5600
Mailing Address - Street 1:568 RUIN CREEK RD
Mailing Address - Street 2:SUITE 003
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5921
Mailing Address - Country:US
Mailing Address - Phone:252-492-5600
Mailing Address - Fax:252-492-5685
Practice Address - Street 1:568 RUIN CREEK RD
Practice Address - Street 2:SUITE 003
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5921
Practice Address - Country:US
Practice Address - Phone:252-492-5600
Practice Address - Fax:252-492-5685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4578237600000X
NC93-00478207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty