Goldberg, Gary S

Goldberg, Gary S is an individual health care provider with primary practice located at 1421 Premiere Dr Mankato Clinic@ Wickersham Campus, Mankato MN 56001-6076. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Goldberg, Gary S can be contacted via phone (507) 625-1811.

Contact Information

Primary practice address
1421 Premiere Dr Mankato Clinic@ Wickersham Campus Mankato MN 56001-6076
Phone: (507) 625-1811
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 43508 Minnesota

Profile Details

NPI number 1013995034
LBN Legal business name Goldberg, Gary S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2006
Last updated Jul 10th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013995034 NPPES
Minnesota Other 140754 UCARE
Minnesota Other 340019399 UCARE
Minnesota Other HP34028 UCARE
Minnesota Other 1808800 UCARE
Minnesota Other 1900310 UCARE
Minnesota Other 0568394 UCARE
Minnesota MEDICAID 392183200 UCARE
Minnesota Other 47D36GO UCARE
Minnesota Other NA2951028013 UCARE

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