Individual
DAVID GOLDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3630 GUION RD, INDIANAPOLIS, IN 46222-1616
(317) 920-7139
Mailing address
6626E 75TH ST 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01023645
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100358570
—
IN
01
—
P00176834
RAILROAD MEDICARE
IN
01
—
P01512422
RAILROAD PTAN
IN
Enumeration date
06/12/2006
Last updated
05/12/2016
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