Provider Demographics
NPI:1831179514
Name:GOLDENBERG, ROBERT ARLIN (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ARLIN
Last Name:GOLDENBERG
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 1:1 CHILDRENS PLZ
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1873
Mailing Address - Country:US
Mailing Address - Phone:937-641-3000
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS PLZ
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404
Practice Address - Country:US
Practice Address - Phone:937-641-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35034453207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
311777214OtherCOVENTANT FAMILY
0297692OtherBCMH
311777214OtherAARP
50217OtherHEALTHSOURCE
OH0297692Medicaid
1000560OtherEVERCARE
D3445303OtherHUMANA CHOICE CARE
311777214OtherDIRECT CARE AMERICA
311777214OtherFIRST HEALTH
000000211218OtherANTHEM
100302OtherDAYMED
2597202OtherAETNA
311777214OtherCIGNA
311777214OtherCREATIVE HEALTH
311777214030OtherCARESOURCE
311777214OtherGEHA
311777214OtherHEALTH SERVICES PREFERRED
000000211218OtherANTHEM
D3445303OtherHUMANA CHOICE CARE