Individual
DR. ROGER STEVEN GOLOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1122 DRUID RD E, CLEARWATER, FL 33756-4100
(727) 461-2282
Mailing address
1122 DRUID RD E, CLEARWATER, FL 33756-4100
(727) 461-2282
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
ME0021279
FL
207NS0135X
Procedural Dermatology Physician
Primary
0021279
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0305012
UNITED HEALTH CARE
FL
01
—
2127587
AETNA
FL
01
—
2147510
PROVIDER NUMBER
FL
01
—
77445
MEDICARE GROUP PROV NUMBE
FL
01
—
78014Z
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/19/2005
Last updated
12/07/2007
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