Provider Demographics
NPI:1376527754
Name:GOLDMAN, NEAL D (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:D
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 GREENWAY RD STE A
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4991
Mailing Address - Country:US
Mailing Address - Phone:828-278-9230
Mailing Address - Fax:828-263-5686
Practice Address - Street 1:717 GREENWAY RD STE A
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4991
Practice Address - Country:US
Practice Address - Phone:828-278-9230
Practice Address - Fax:828-263-5686
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9901411207YS0123X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7052087OtherAETNA
12332OtherBCBS
31887OtherPARTNERS
91536OtherMEDCOST
31887OtherPARTNERS
SCQ01411Medicaid
7052087OtherAETNA
WV2005458000Medicaid
G59780Medicare UPIN
SCQ01411Medicaid