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NPI Code Detail

MEDICARE: ADAM DREW GOLDSTEIN M.D.

MEDICARE: ADAM DREW GOLDSTEIN 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
1207L00000XAnesthesiology Physician038740CT

Other Identifiers

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

General Provider Information

NPI Number : 1093715427
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM DREW GOLDSTEIN M.D.
Provider Business Mailing Address
First Line : 3998 FAIR RIDGE DR
Second Line : ST 300
City : FAIRFAX
State : VA
Zip : 22033-2907
Country : US
Telephone Number : 703-295-9360
Fax Number : 703-766-9725
Provider Business Practice Location Address
First Line : 326 WASHINGTON ST
Second Line :
City : NORWICH
State : CT
Zip : 06360-2740
Country : US
Telephone Number : 860-889-8331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 03/18/2015

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