Individual
DR. JACOB S GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 S NEW BALLAS RD STE 2015, SAINT LOUIS, MO 63141-8253
(314) 362-8065
Mailing address
625 S NEW BALLAS RD STE 2015, SAINT LOUIS, MO 63141-8253
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2012019664
MO
207RC0000X
Cardiovascular Disease Physician
2013044286
MO
207RI0011X
Interventional Cardiology Physician
Primary
2013044286
MO
Other
Enumeration date
06/21/2012
Last updated
01/22/2020
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