Individual
DR. JOHN D GOLDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11725 ILLINOIS ST, SUITE 445, CARMEL, IN 46032-3010
(317) 844-7059
(317) 819-0044
Mailing address
10201 N ILLINOIS ST STE 110, CARMEL, IN 46290-1172
(317) 844-7059
(317) 819-0044
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01048458A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040011990
MEDICARE RAILROAD
IN
05
—
200166360
—
IN
01
—
266180H71
INDIVIDUAL MEDICARE PTAN
IN
01
—
Q00256328
RAILROAD MEDICARE
IN
Enumeration date
01/04/2007
Last updated
06/21/2024
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