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:
Map and Directions
Authorized official contact:
Name: Goldstein, Mitchell Robert Doctor of Medicine (MD)
Phone: (574) 532-0153

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700196698 NPPES
Indiana MEDICAID 100346980B

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