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NPI Code Detail

MEDICARE: DR. DEBORAH GOFREED M.D.

MEDICARE: DR. DEBORAH GOFREED 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
1207RP1001XPulmonary Disease Physician0101036617VA
2207RS0012XSleep Medicine (Internal Medicine) Physician0101036617VA

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 : 1982792420
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBORAH GOFREED M.D.
Provider Business Mailing Address
First Line : 2901 TELESTAR CT STE 300
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22042-1263
Country : US
Telephone Number : 703-591-1688
Fax Number : 703-591-1445
Provider Business Practice Location Address
First Line : 1005 N GLEBE RD # 705
Second Line :
City : ARLINGTON
State : VA
Zip : 22201-5718
Country : US
Telephone Number : 703-524-7202
Fax Number : 703-516-4501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 07/21/2022

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