Organization Active NPI

Dalcoma Pharmacopoeia, LLC

  • Neurological Surgery Physician
  • Clinton Township, MI
National Provider Identifier
1174103634
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
DALCOMA PHARMACOPOEIA, LLC
Practice address
43475 Dalcoma Dr Ste 150
Clinton Township, MI 48038-3594
Phone
(586) 421-7440
Fax
(248) 281-9955
NPI assigned
Apr 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mark L Goldberger, DONPI 1740277425
Title
Manager
Phone
(248) 320-6101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X

Addresses

Primary practice location

43475 Dalcoma Dr Ste 150
Clinton Township, MI 48038-3594

Mailing address

43475 Dalcoma Dr Ste 150
Clinton Township, MI 48038-3594
Phone (586) 421-7440

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1174103634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR STE 150",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383594",
            "telephone_number": "586-421-7440",
            "fax_number": "248-281-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR STE 150",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383594",
            "telephone_number": "586-421-7440",
            "fax_number": "248-281-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALCOMA PHARMACOPOEIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "GOLDBERGER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-320-6101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.