Individual
GLENN D GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11550 GRANADA LN, LEAWOOD, KS 66211-1453
(913) 451-7546
Mailing address
11550 GRANADA LN, LEAWOOD, KS 66211-1453
(913) 451-7546
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
04-19680
KS
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
04-19680
KS
Other
Enumeration date
06/03/2006
Last updated
08/04/2017
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