| 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 | 34 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 |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Green Mountain Dermatology Pllc | 4688011992 | 14 |
| Entity Name | University Of Vermont Medical Center Inc |
|---|---|
| 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 | Green Mountain Dermatology 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 Goodrich, 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 | |
Margaret Spencer Johnston, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 354 Mountain View Dr Ste 300, Colchester, VT 05446 Phone: 802-864-0192 | |
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 |