Individual
MICHAEL H. GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8134 OLD KEENE MILL RD, SUITE 300, SPRINGFIELD, VA 22152-1800
(703) 451-6111
(703) 451-6247
Mailing address
8134 OLD KEENE MILL RD, SUITE 300, SPRINGFIELD, VA 22152-1800
(703) 451-6111
(703) 451-6247
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101030490
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006379613
—
VA
01
—
541168250
TAX IDENTIFICATION NUMBER
VA
Enumeration date
02/27/2006
Last updated
12/03/2009
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