Provider Demographics
NPI:1780744268
Name:GOLDEN, JOHN SETH (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SETH
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:PPQA MEDICARE COMPLIANCE UNIT 6 WEST
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:12011 LEE JACKSON MEMORIAL HWY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-4512
Practice Address - Country:US
Practice Address - Phone:703-383-5411
Practice Address - Fax:703-383-5547
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2024-10-22
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Provider Licenses
StateLicense IDTaxonomies
DCMD19249207R00000X
MDD41762207RC0000X
HIMD-24218207RI0011X
VA0101046617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
E95047Medicare UPIN
683052M92Medicare ID - Type Unspecified