Goldenberg, Bradley

Goldenberg, Bradley is an individual health care provider with primary practice located at 15200 Community Rd , Gulfport MS 39503-3085. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Goldenberg, Bradley can be contacted via phone (228) 575-7022.

Contact Information

Primary practice address
15200 Community Rd Gulfport MS 39503-3085
Phone: (228) 575-7022
Fax: (228) 575-7097
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 01070390A Indiana
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 674 Wisconsin
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 329609 Louisiana
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 036074881 Illinois
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 28322 Mississippi

Profile Details

NPI number 1477595239
LBN Legal business name Goldenberg, Bradley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Mar 7th, 2023 - about 3 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 1477595239 NPPES
Mississippi MEDICAID 1J4304
Mississippi MEDICAID 1L7105
Mississippi MEDICAID 036074881
Mississippi Other 01070390A
Mississippi MEDICAID 100098179
Mississippi Other 01070390B
Mississippi Other 000001071268

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