Basic Information
| Provider Information | |||||||||
| NPI: | 1881885416 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LAWRENCE N GOLDMAN MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9788 | ||||||||
| Address2: | |||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008012788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407141122 | ||||||||
| FaxNumber: | 3407154313 | ||||||||
| Practice Location | |||||||||
| Address1: | 9149 ESTATE THOMAS | ||||||||
| Address2: | PARAGON MEDICAL BUILDING #208 | ||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008022615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407141122 | ||||||||
| FaxNumber: | 3407154313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2007 | ||||||||
| LastUpdateDate: | 10/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | GOLDMAN | ||||||||
| AuthorizedOfficialFirstName: | LAWRENCE | ||||||||
| AuthorizedOfficialMiddleName: | NORMAN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENTT | ||||||||
| AuthorizedOfficialTelephone: | 3407141122 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | VI1128 | VI | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.