Individual
DAVID A GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
200 PATEWOOD DR, STE C150, GREENVILLE, SC 29615-3593
(864) 454-0904
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1367
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-2312101
BLUE CHOICE
SC
01
—
20-2312101
FOCUS
—
01
—
607756100
DEPT OF LABOR
SC
01
—
7761758
AETNA
SC
01
—
9799717
CIGNA
SC
01
—
DD4407
MEDICARE RAILROAD GRP
SC
01
—
E2939
MEDCOST
SC
01
—
P00228285
MEDICARE RAILROAD
SC
05
—
TH0916
—
SC
Enumeration date
10/27/2006
Last updated
11/06/2015
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