Goldberg, Michael W
Goldberg, Michael W is an sole proprietor health care provider with primary practice located at 113 Hawk Drive , Dulce NM 87528. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Goldberg, Michael W can be contacted via phone (505) 759-2954.Contact Information
Primary practice address
113 Hawk Drive
Dulce NM 87528
Phone: (505) 759-2954
Fax: (505) 759-1349
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 103TS0200X | 308194 | New Mexico |
Profile Details
| NPI number | 1043340987 |
|---|---|
| LBN Legal business name | Goldberg, Michael W |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 7th, 2007 |
| 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 | 1043340987 | NPPES |
| New Mexico | MEDICAID | 27087859 |
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