Mitchell R Goldstein, Md
LBN: Mitchell R Goldstein, Md
Mitchell R Goldstein, Md is an health care organization with primary practice located at 107 N Eddy St , South Bend IN 46617-2920. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Agencies / Community/Behavioral Health. Behavioral Health & Social Service Providers / Professional is the primary health care specialty.
Mitchell R Goldstein, Md can be contacted via phone (574) 532-0153, or through Goldstein, Mitchell Robert via phone (574) 532-0153.
Contact Information
Primary practice address
107 N Eddy St
South Bend IN 46617-2920
Phone: (574) 532-0153
Fax: (574) 246-1634
Website:
Authorized official contact:
Name: Goldstein, Mitchell Robert Doctor of Medicine (MD)
Phone: (574) 532-0153
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | ||
| Agencies / Community/Behavioral Health | 251S00000X |
Profile Details
| NPI number | 1700196698 |
|---|---|
| LBN Legal business name | Mitchell R Goldstein, Md |
| DBA Doing business as | |
| Authorized official | Goldstein, Mitchell Robert Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 14th, 2010 |
| Last updated | Oct 18th, 2010 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700196698 | NPPES |
| Indiana | MEDICAID | 100346980B |
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