Basic Information
| Provider Information | |||||||||
| NPI: | 1558366633 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOLDING | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1643 NW 136TH AVE BLDG H | ||||||||
| Address2: | |||||||||
| City: | SUNRISE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333232857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543772939 | ||||||||
| FaxNumber: | 8655607110 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 MARVEL RD | ||||||||
| Address2: | |||||||||
| City: | MILFORD | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199631740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543772939 | ||||||||
| FaxNumber: | 8655607110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2005 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | D35229 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207R00000X | C10024864 | DE | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | D35229 | 01 | MD | STATE LICENSE | OTHER |