Individual
MR. PHILLIP DANIEL GOLDSBOROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12145 ELM ST, PRINCESS ANNE, MD 21853-1358
(410) 651-2204
(410) 651-0790
Mailing address
PO BOX 1978, SALISBURY, MD 21802-1978
(410) 749-1015
(410) 749-0654
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R193305
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119591300
—
MD
Enumeration date
03/09/2023
Last updated
07/31/2024
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