Provider Demographics
NPI:1588867626
Name:GOLDEN, PETER II (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:GOLDEN
Suffix:II
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 1:312 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1801
Mailing Address - Country:US
Mailing Address - Phone:330-762-0591
Mailing Address - Fax:330-762-2242
Practice Address - Street 1:312 LOCUST ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1801
Practice Address - Country:US
Practice Address - Phone:330-762-0591
Practice Address - Fax:330-762-2242
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2012-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4274612084P0804X
OH0883762084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry