Individual
DR. GLENN ROBERT GOLDFARB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2345 CHESTERFIELD AVE, SUITE 303, CHARLESTON, WV 25304-1064
(304) 343-0149
(304) 343-2587
Mailing address
2345 CHESTERFIELD AVE, SUITE 303, CHARLESTON, WV 25304-1062
(304) 343-0149
(304) 343-2587
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15212
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089743000
—
WV
Enumeration date
04/10/2006
Last updated
12/19/2011
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