Individual
MARK GOLDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
39TH & MARKET STREET, 2 MYRIN, PHILADELPHIA, PA 19104
(215) 662-8229
Mailing address
3624 MARKET STREET STE 560W, UPHS OFFICE OF MEDICAL AFFAIRS, PHILADELPHIA, PA 19104
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD029139E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009173660005
—
PA
Enumeration date
07/13/2006
Last updated
07/08/2007
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