Individual
DR. MARK EDWARD GOLDSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
262 CHINKAPIN WAY, WESTERVILLE, OH 43081-4523
(614) 890-7300
Mailing address
262 CHINKAPIN WAY, WESTERVILLE, OH 43081-4523
(614) 890-7300
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
038474
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000117883
ANTHEM
OH
05
—
0284320
—
OH
01
—
038474
MEDICAL LICENSE
OH
01
—
31-0993335-01
WC-GP
OH
01
—
3109933350226
CARESOURCE
OH
01
—
NONE
NONE
OH
Enumeration date
11/02/2006
Last updated
03/07/2023
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