Provider Demographics
NPI:1528058070
Name:GOLDING, DANIEL MARK (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:MARK
Last Name:GOLDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7595 ANAGRAM DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7399
Mailing Address - Country:US
Mailing Address - Phone:612-573-2200
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:7595 ANAGRAM DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7399
Practice Address - Country:US
Practice Address - Phone:612-573-2200
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI101282085R0202X
MN663602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
003118404OtherCT MED ASSISTANCE
1600025OtherUNITEDHEALTHPLANS
300101938OtherRAILROADMEDICARE
7007228OtherRIMEDICALASSISTANCE
010128OtherBLUESHIELD
3205118OtherMASSMEDICAID
720087501OtherCIGNA
000000001988OtherNHPRI
007007236OtherHOSPITALPIN
405086OtherBLUECHIP
101280OtherTUFTS
3205118OtherHEALTHYSTART