Provider Demographics
NPI:1518951284
Name:GOLDSTEIN, ANDREW H (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:H
Last Name:GOLDSTEIN
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 1:10117 N 92ND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4555
Mailing Address - Country:US
Mailing Address - Phone:480-767-5544
Mailing Address - Fax:480-245-7083
Practice Address - Street 1:10117 N. 92ND ST, STE 101
Practice Address - Street 2:101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-767-5544
Practice Address - Fax:480-245-7083
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3004208G00000X
AZ29641208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ636491Medicaid
AZZ126835Medicare PIN