Provider Demographics
NPI:1215463328
Name:GOLDMAN, BETH SILVER (MSPT)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:SILVER
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 BAXTER ST STE 361
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3800
Mailing Address - Country:US
Mailing Address - Phone:704-377-0020
Mailing Address - Fax:
Practice Address - Street 1:1300 BAXTER ST STE 361
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3800
Practice Address - Country:US
Practice Address - Phone:704-377-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP12450225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist