| Organization Name: | STEPHEN I. GOLDMAN, D.O., P.C. |
| NPI Number: | 1144559642 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN IRA GOLDMAN (PRESIDENT) |
| Mailing Address: | 23995 Novi Rd Suite C103 Novi |
| State: | MI US |
| Postal Code: | 483755439 |
| Phone Number: | 2483801900 |
| Fax Number: | 2483800605 |
| NPI Enumeration Date: | 12/11/2009 |
| NPI Last Update Date: | 12/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |