Provider Demographics
NPI:1639604770
Name:GOSWICK, ANNA ELIZABETH (MD)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:ELIZABETH
Last Name:GOSWICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:ELIZABETH
Other - Last Name:HACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:590 MANNING DR
Mailing Address - Street 2:CB#7595
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-6119
Mailing Address - Country:US
Mailing Address - Phone:984-974-4544
Mailing Address - Fax:919-966-6125
Practice Address - Street 1:930 3RD ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6967
Practice Address - Country:US
Practice Address - Phone:336-832-3200
Practice Address - Fax:336-890-3290
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC227460390200000X
NC2020-01296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty