Provider Demographics
NPI:1285618520
Name:GOLDMAN, MATTHEW A (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
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 1:500 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2391
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:800-243-1455
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-5690
Practice Address - Fax:717-531-5009
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5541207W00000X
PAMD483918207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144067902Medicaid
TX8C2231Medicare ID - Type UnspecifiedMEDICARE