Healthcare Provider Details

I. General information

NPI: 1801829262
Provider Name (Legal Business Name): JOSEPH DANIEL GOTTFRIED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NE NEFF RD
BEND OR
97701-6015
US

IV. Provider business mailing address

119 W 72ND ST # 342
NEW YORK NY
10023-3201
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-6892
  • Fax: 541-706-6813
Mailing address:
  • Phone: 646-894-3294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2002-00227
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200200227
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: