Goldberg, Mark
Goldberg, Mark is an individual health care provider with primary practice located at 36001 Euclid Ave Suite B-6, Willoughby OH 44094-4643. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Goldberg, Mark can be contacted via phone (440) 953-2500.Contact Information
Primary practice address
36001 Euclid Ave Suite B-6
Willoughby OH 44094-4643
Phone: (440) 953-2500
Fax: (440) 953-2772
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 35-085145 | Ohio |
Profile Details
| NPI number | 1366498636 |
|---|---|
| LBN Legal business name | Goldberg, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 26th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366498636 | NPPES |
| Ohio | MEDICAID | 2538034 |
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