Individual
SAMUEL GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10451 TWIN RIVERS RD, COLUMBIA, MD 21044-2388
(410) 997-3557
(410) 964-1791
Mailing address
4623 FALLS RD, BALTIMORE, MD 21209-4914
(410) 366-1980
(410) 366-8530
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
D0024347
MD
2084N0600X
Clinical Neurophysiology Physician
M17939
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034197-000
MAGELLAN
MD
01
—
115468
KAISER
MD
01
—
2143757000
AMERIHEALTH
MD
01
—
347492
MAMSI
MD
05
—
400491400
—
MD
01
—
4281365
AETNA
MD
01
—
PVPB129834
APS HEALTHCARE
MD
01
—
T541-0032
CAREFIRST
MD
Enumeration date
09/02/2006
Last updated
10/16/2008
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