Individual
JAY STEPHEN GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
430 CLAREMONT CT, SUITE 213, COLONIAL HEIGHTS, VA 23834-1770
(804) 520-2626
(804) 520-0626
Mailing address
430 CLAREMONT CT, SUITE 213, COLONIAL HEIGHTS, VA 23834-1770
(804) 520-2626
(804) 520-0626
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101021527
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477654291
BCBS
VA
05
—
1477654291
—
VA
Enumeration date
09/26/2006
Last updated
01/29/2009
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