Dr Glenn David Goldman, MD | |
354 Mountain View Dr Ste 300, Colchester, VT 05446-5988 | |
(802) 864-0192 | |
(802) 860-4919 |
Full Name | Dr Glenn David Goldman |
---|---|
Gender | Male |
Speciality | Dermatology |
Experience | 33 Years |
Location | 354 Mountain View Dr Ste 300, Colchester, Vermont |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992717458 | NPI | - | NPPES |
0VN1395 | Medicaid | VT | |
01669910 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ND0101X | Dermatology - Mohs-micrographic Surgery | 0420009351 (Vermont) | Primary |
207N00000X | Dermatology | 0420009351 (Vermont) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Univ. Of Vermont - Fletcher Allen Health Care | Burlington, VT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Four Seasons Dermatology Llc | 8820062946 | 12 |
Entity Name | University Of Vermont Medical Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659309615 PECOS PAC ID: 3779491071 Enrollment ID: O20040406001047 |
Entity Name | Four Seasons Dermatology Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790737393 PECOS PAC ID: 8820062946 Enrollment ID: O20040824001173 |
Entity Name | Integrated Dermatology Of Vermont Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093577827 PECOS PAC ID: 4688011992 Enrollment ID: O20240322000288 |
Mailing Address | Practice Location Address |
---|---|
Dr Glenn David Goldman, MD 358 Chamberlin Ln, Williston, VT 05495-4406 Ph: () - | Dr Glenn David Goldman, MD 354 Mountain View Dr Ste 300, Colchester, VT 05446-5988 Ph: (802) 864-0192 |
Anita Louise Licata, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 354 Mountain View Dr, Suite 300, Colchester, VT 05446 Phone: 802-864-0192 Fax: 802-860-4919 | |
Ms. Mary B Harkin, N.P. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 354 Mountain View Dr, Suite 300, Colchester, VT 05446 Phone: 802-864-0192 Fax: 802-860-4919 |