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NPI Code Detail

MEDICARE: DR. GREGG ADAM SOIFER M.D.

MEDICARE: DR. GREGG ADAM SOIFER 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
1207Q00000XFamily Medicine Physician88962GA
2208100000XPhysical Medicine & Rehabilitation Physician31798AL
3208100000XPhysical Medicine & Rehabilitation Physician88962GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111378617OTHERALCAQH

General Provider Information

NPI Number : 1679545537
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGG ADAM SOIFER M.D.
Provider Business Mailing Address
First Line : PO BOX 678402
Second Line :
City : DALLAS
State : TX
Zip : 75267-8402
Country : US
Telephone Number : 817-284-9850
Fax Number : 817-284-9859
Provider Business Practice Location Address
First Line : 1165 SANDERS RD
Second Line :
City : CUMMING
State : GA
Zip : 30041-5965
Country : US
Telephone Number : 800-324-4777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 03/31/2025

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