Type | Person | [sources] | |||
---|---|---|---|---|---|
Name | Keith D. Goldblum · Keith Goldblum | [sources] | |||
Birth date | [sources] | ||||
Nationality | not available | [sources] | |||
Country | United States of America | [sources] | |||
Description | Provider ID: 0804311 | [sources] | |||
First name | Keith | [sources] | |||
ID Number | 35.060544 (OH) | [sources] | |||
Last name | Goldblum | [sources] | |||
Middle name | D. | [sources] | |||
NPI | 1316924616 | [sources] | |||
Sector | 20 - Physician/Osteopath Individual | [sources] | |||
Title | MD | [sources] | |||
Address | (OH), (OH) | [sources] | |||
Last change | Last processed | First seen |
Medical providers who are precluded from participation in the Medical Assistance Program
United States of America · DHS
Medical providers excluded or suspended from Ohio's Medicaid program.
United States of America · ODM
us-medoh-ad2c6963b948a36c55a315471d31b7b36dcf1ca6
· us-medpa-7f0175f31963de777f9cfceff267a61f9c44dbce
For experts: raw data explorer
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Sanctions | |||||
---|---|---|---|---|---|
Country | Authority | Program | Start date | End date | |
United States of America | Department of Human Services | - |
Address | ||
---|---|---|
Full address | Country | |
(OH), (OH) · OH, OH | United States of America |
United States of America | Ohio Department of Medicaid | - | - |