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Individual
GARY S GOLDBERG
Active
Individual
GARY S GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
43508
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0568394
MEDICAID
IA
01
—
140754
UCARE
MN
01
—
1808800
AMERICAS PPO
MN
01
—
1900310
MEDICA
MN
01
—
340019399
RR MEDICARE
—
05
—
392183200
—
MN
01
—
47D36GO
BCBS
MN
01
—
HP34028
HEALTH PARTNERS
MN
01
—
NA2951028013
PREFFERED ONE
MN
Enumeration date
01/09/2006
Last updated
07/10/2020
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