Individual
DAVID D GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3033 KETTERING BLVD, SUITE 100, MORAINE, OH 45439-1962
(937) 293-2133
(937) 293-2161
Mailing address
3033 KETTERING BLVD, SUITE 100, MORAINE, OH 45439-1962
(937) 293-2133
(937) 293-2161
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34-00-2116G
OH
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
34-00-2116G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000226414
ANTHEM
OH
05
—
0203998
—
OH
Enumeration date
07/26/2005
Last updated
08/16/2011
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