MEDICARE: DR. MARI ANN MCGOFF MD

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
1	207R00000X	Internal Medicine Physician	MD047589L	PA
2	208M00000X	Hospitalist Physician	MD047589L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114929197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARI ANN MCGOFF MD

Provider Business Mailing Address
First Line	:	PO BOX 783311
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-3311
Country	:	US
Telephone Number	:	484-884-4500
Fax Number	:	484-884-0699

Provider Business Practice Location Address
First Line	:	2545 SCHOENERSVILLE RD
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-7300
Country	:	US
Telephone Number	:	484-884-9677
Fax Number	:	484-884-9297

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	01/19/2022

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