Individual
DR. NORMAN J GOLDBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1904 S MAIN ST STE 114, WAKE FOREST, NC 27587-5030
(919) 554-8539
(919) 554-9686
Mailing address
105 SW CARY PKWY STE 105, CARY, NC 27511-5600
(919) 863-9441
(919) 863-9442
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01043533A
IN
208800000X
Urology Physician
Primary
2007-00855
NC
208800000X
Urology Physician
35-060154G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000111097
ANTHEM
IN
05
—
0114192
—
OH
05
—
200022490
—
IN
01
—
340009455
TRAVELERS
IN
Enumeration date
11/09/2005
Last updated
10/27/2020
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