Individual
DR. GLENN DAVID GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
354 MOUNTAIN VIEW DR STE 300, COLCHESTER, VT 05446-5988
(802) 864-0192
(802) 860-4919
Mailing address
358 CHAMBERLIN LN, WILLISTON, VT 05495-4406
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
0420009351
VT
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
0420009351
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01669910
—
NY
05
—
0VN1395
—
VT
Enumeration date
08/13/2006
Last updated
03/05/2024
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