Provider Demographics
NPI:1174969422
Name:GOLDFIELD, FRANK SAMUEL (LMT)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:SAMUEL
Last Name:GOLDFIELD
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:BRADDOCK HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21714-0220
Mailing Address - Country:US
Mailing Address - Phone:301-979-9733
Mailing Address - Fax:
Practice Address - Street 1:6816 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:BRADDOCK HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21714-0220
Practice Address - Country:US
Practice Address - Phone:301-979-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM02540174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist