Individual
DR. JOHN GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5701 W 119TH ST, SUITE 240, OVERLAND PARK, KS 66209-3722
(913) 345-8500
(913) 345-3784
Mailing address
5701 W 119TH ST, SUITE 240, OVERLAND PARK, KS 66209-3722
(913) 345-8500
(913) 345-3784
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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