Provider Demographics
NPI:1831178094
Name:GOLD, ALBERT MARK (PHD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:MARK
Last Name:GOLD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:BERT
Other - Middle Name:
Other - Last Name:GOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6811 KINGFISHER CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-9522
Mailing Address - Country:US
Mailing Address - Phone:301-360-0699
Mailing Address - Fax:
Practice Address - Street 1:6811 KINGFISHER CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-9522
Practice Address - Country:US
Practice Address - Phone:301-360-0699
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD96059207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics