Provider Demographics
NPI:1801991435
Name:GOLDEN, DAVID JOHN (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:694 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3500
Mailing Address - Country:US
Mailing Address - Phone:401-884-2821
Mailing Address - Fax:401-884-4350
Practice Address - Street 1:694 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3500
Practice Address - Country:US
Practice Address - Phone:401-884-2821
Practice Address - Fax:401-884-4350
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDPM00320213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7058052Medicaid
RI489004216Medicaid
RI489004216Medicaid
V07153Medicare UPIN