Provider Demographics
NPI:1275518565
Name:GOOZH, JOEL LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:LEE
Last Name:GOOZH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20861-0157
Mailing Address - Country:US
Mailing Address - Phone:301-570-9700
Mailing Address - Fax:301-260-2838
Practice Address - Street 1:10401 OLD GEORGETOWN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1911
Practice Address - Country:US
Practice Address - Phone:301-897-2757
Practice Address - Fax:301-260-2838
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD16495207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1275518565OtherNPI IDENTIFIER
C61862Medicare UPIN
G02630J01Medicare PIN