Individual
DR. MARK GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7238 MECHANICSVILLE TPKE, MECHANICSVILLE, VA 23111-3502
(804) 559-9900
(804) 559-6530
Mailing address
PO BOX 758963, BALTIMORE, MD 21275-8963
(804) 968-5700
(804) 217-7991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101055198
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005625823
—
VA
Enumeration date
07/20/2006
Last updated
01/15/2013
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