Provider Demographics
NPI:1003988353
Name:RADOFF, GEOFFREY PETER (MD)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:PETER
Last Name:RADOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9110 N 81ST STREET
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258
Mailing Address - Country:US
Mailing Address - Phone:480-607-0621
Mailing Address - Fax:480-596-9254
Practice Address - Street 1:2525 WEST GREENWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023
Practice Address - Country:US
Practice Address - Phone:602-993-0200
Practice Address - Fax:602-993-0207
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9881207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0877330OtherBCBS
AZZ119235Medicare PIN
AZAZ0877330OtherBCBS