Provider Demographics
NPI:1548643562
Name:GOLDMAN, ERIN (DO)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14240 LABELLE ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-6918
Mailing Address - Country:US
Mailing Address - Phone:248-420-9003
Mailing Address - Fax:
Practice Address - Street 1:16001 W NINE MILE ROAD
Practice Address - Street 2:PROVIDENCE HOSPITAL MEDICAL CTR. GRAD MED EDUCATION
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-849-3151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101021953207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine