Organization
GROVE PARK PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARITA GOLDAR MD (OWNER)
(336) 570-0354
Entity
Organization
Contact information
Practice address
113 TRAIL ONE, BURLINGTON, NC 27215-5531
(336) 570-0354
(336) 570-0356
Mailing address
113 TRAIL ONE, BURLINGTON, NC 27215-5531
(336) 570-0354
(336) 570-0356
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2004-00119
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89137W6
—
NC
Enumeration date
12/01/2008
Last updated
12/01/2008
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