Provider Demographics
NPI:1447280276
Name:GOLDSTEIN, JOEL A (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:A
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOEL
Other - Middle Name:ARNOLD
Other - Last Name:GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1000 CORPORATE CENTER DR
Mailing Address - Street 2:STE 220
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260
Mailing Address - Country:US
Mailing Address - Phone:770-960-9999
Mailing Address - Fax:770-960-0931
Practice Address - Street 1:1000 CORPORATE CENTER DR
Practice Address - Street 2:STE 220
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260
Practice Address - Country:US
Practice Address - Phone:770-960-9999
Practice Address - Fax:770-960-0931
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA014177208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics