Individual
DR. JOHN GOLDBERG
Active
Individual
DR. JOHN GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
422340
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100003160
RAILROAD MEDICARE
GA
05
—
100127110A
—
KS
01
—
17355020
BLUE CROSS BLUE SHIELD
MO
05
—
200300509
—
MO
01
—
431207857
UNITED HEALTHCARE
KS
01
—
709373
AETNA
KS
Enumeration date
07/17/2006
Last updated
06/23/2010
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