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NPI Code Detail

MEDICARE: DR. ANDREA ELIZABETH GOLDBERG MD

MEDICARE: DR. ANDREA ELIZABETH GOLDBERG 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
1207R00000XInternal Medicine Physician44531AZ

General Provider Information

NPI Number : 1013189166
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA ELIZABETH GOLDBERG MD
Provider Business Mailing Address
First Line : 4375 E IRMA LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85050
Country : US
Telephone Number : 480-890-5800
Fax Number : 480-890-5920
Provider Business Practice Location Address
First Line : 4375 E IRMA LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85050-4312
Country : US
Telephone Number : 480-890-5800
Fax Number : 480-890-5920
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2008
Last Update Date : 06/28/2018

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