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NPI Code Detail

MEDICARE: DR. PETER GOODFIELD M.D.

MEDICARE: DR. PETER GOODFIELD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician28976NC
2207R00000XInternal Medicine Physician28976NC

General Provider Information

NPI Number : 1043216054
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER GOODFIELD M.D.
Provider Business Mailing Address
First Line : PO BOX 602381
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-2381
Country : US
Telephone Number : 828-693-5010
Fax Number : 828-693-7003
Provider Business Practice Location Address
First Line : 691 BLYTHE STREET CT
Second Line :
City : HENDERSONVILLE
State : NC
Zip : 28739-4095
Country : US
Telephone Number : 828-693-5010
Fax Number : 828-693-7003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 02/25/2016

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