Individual
MITCHELL B GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
(218) 846-2114
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35264
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10974
—
ND
Enumeration date
07/18/2006
Last updated
03/29/2022
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