Provider Demographics
NPI:1104062686
Name:GOLDMAN, PETER HARRY (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:HARRY
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 1:142 SPRINGHOUSE RD.
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4507
Mailing Address - Country:US
Mailing Address - Phone:610-398-7460
Mailing Address - Fax:610-397-7460
Practice Address - Street 1:142 SPRINGHOUSE RD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4507
Practice Address - Country:US
Practice Address - Phone:610-398-7460
Practice Address - Fax:610-397-7460
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD011185E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease