Provider Demographics
NPI:1366402208
Name:GOLD, STEPHEN F (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:GOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2920 MARIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2104
Mailing Address - Country:US
Mailing Address - Phone:717-898-2356
Mailing Address - Fax:717-898-3872
Practice Address - Street 1:2920 MARIETTA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2104
Practice Address - Country:US
Practice Address - Phone:717-898-2356
Practice Address - Fax:717-898-3872
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS007509L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA14115930101Medicaid
PAF23663Medicare UPIN
PA003107Medicare ID - Type Unspecified