Goldstein, Mitchell Robert

Goldstein, Mitchell Robert is an sole proprietor health care provider with primary practice located at 107 N Eddy St , South Bend IN 46617-2920. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Goldstein, Mitchell Robert can be contacted via phone (574) 246-1036.

Contact Information

Primary practice address
107 N Eddy St South Bend IN 46617-2920
Phone: (574) 246-1036
Fax: (574) 246-1634
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 01041575 Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01041575 Indiana

Profile Details

NPI number 1659335636
LBN Legal business name Goldstein, Mitchell Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 14th, 2006
Last updated Nov 25th, 2020 - about 4 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 1659335636 NPPES
Indiana MEDICAID 100346980B
Indiana MEDICAID 100346980A

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