Individual
DR. MARCEL ALEXANDER GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3025 WEST CHERRY LANE, SUITE B, MERIDIAN, ID 83642-8531
(208) 302-6400
(208) 302-6455
Mailing address
3340 EAST GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-6400
(208) 302-6455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A54953
CA
207Q00000X
Family Medicine Physician
Primary
M-10788
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A549530
BLUE SHIELD PIN
CA
Enumeration date
06/09/2006
Last updated
11/10/2016
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