1245266907 NPI number — ELLIOT R GOLDSTEIN MD & JOEL R SCHULMAN MD PA

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245266907 NPI number — ELLIOT R GOLDSTEIN MD & JOEL R SCHULMAN MD PA

Employer Identification Number (EIN):

Provider Organization Name:

ELLIOT R GOLDSTEIN MD & JOEL R SCHULMAN MD PA

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

Provider Other Organization Name Type Code:

6

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1245266907

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

12/14/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

6000 EXECUTIVE BLVD

Provider Second Line Business Mailing Address:

SUITE 300

Provider Business Mailing Address City Name:

ROCKVILLE

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

20852-3803

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

301-468-8999

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

5530 WISCONSIN AVE

Provider Second Line Business Practice Location Address:

SUITE 645

Provider Business Practice Location Address City Name:

CHEVY CHASE

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

20815-4404

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

301-656-4545

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

06/24/2006

Authorized Official Last Name:

WEISEL

Authorized Official First Name:

LORI

Authorized Official Middle Name:

Authorized Official Title or Position:

PRACTICE ADMINISTRATOR

Authorized Official Telephone Number:

240-207-2030

• Taxonomy code: 207X00000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208800000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 213E00000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207R00000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 832407 . This is a "MDIPA GROUP NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 404178 . This is a "CAREFIRST POS GROUP #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 832407 . This is a "OPTIMUM CHOICE GROUP #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 832407 . This is a "ALLIANCE GROUP NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: S204 . This is a "BSMD GROUP NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 832407 . This is a "MAMSI GROUP NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 9070 . This is a "BSDC GROUP NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".