Provider Demographics
NPI:1164425252
Name:GOLDFINGER, TEDD MARK (DO)
Entity Type:Individual
Prefix:
First Name:TEDD
Middle Name:MARK
Last Name:GOLDFINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 N LA CHOLLA BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3552
Mailing Address - Country:US
Mailing Address - Phone:520-545-0953
Mailing Address - Fax:520-545-0954
Practice Address - Street 1:6320 N LA CHOLLA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3552
Practice Address - Country:US
Practice Address - Phone:520-545-0953
Practice Address - Fax:520-545-0954
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ02198207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ259665Medicaid
AZP00132740OtherRAILROAD MEDICARE
AZ005502300OtherCIGNA
AZ10076419OtherPPO NEXT
AZ5016425OtherCCN
AZ100663OtherONE HEALTH PLAN OF AZ
AZ1413OtherARIZONA MEDICAL NETWORK
AZ2591480OtherGHI
AZ4063355OtherAETNA
CA9827534OtherMEDI-CAL
IA0562140Medicaid
AZ52985OtherFIRST HEALTH
AZAZ0860250OtherBCBS OF ARIZONA
AZ1Z2241OtherHEALTH NET
AZ25-00025OtherUNITED HEALTHCARE
AZC98240Medicare UPIN
AZ1Z2241OtherHEALTH NET
AZ005502300OtherCIGNA
AZ259665Medicaid
AZ1413OtherARIZONA MEDICAL NETWORK
AZ4063355OtherAETNA