Individual
MARK DANIEL GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5252 E MAIN ST, MESA, AZ 85205-8022
(480) 396-3222
(480) 396-2298
Mailing address
5252 E MAIN ST, MESA, AZ 85205-8022
(480) 396-3222
(480) 396-2298
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18592
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298704
—
AZ
Enumeration date
08/04/2006
Last updated
09/08/2020
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