MITCHELL R GOLDSTEIN, MD SOUTH BEND, IN

Contact Information

MITCHELL R GOLDSTEIN, MD

107 N EDDY ST
SOUTH BEND, IN 46617-2920

Phone: 574-246-1036
Fax: 574-246-1634
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Child & Adolescent Psychiatry	2084P0804X	86	Physician/Neuropsychiatry
Psychiatry	2084P0800X	26	Physician/Psychiatry

Indicates primary specialty

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NPI Profile & details for MITCHELL R GOLDSTEIN · (Male)

NPI Number	`1659335636`
Status	Active
Credentials	MD
Entity	Individual
Enumeration date	04/14/2006
Last updated	11/25/2020 - About 6 years ago
Sole proprietor ¹	Yes
Identifiers	IN License # 01041575 IN Medicaid 100346980A IN Medicaid 100346980B
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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