Provider Demographics
NPI:1295879393
Name:MEDICAL ASSOCIATES OF CAMBRIDGE INC.
Entity type:Organization
Organization Name:MEDICAL ASSOCIATES OF CAMBRIDGE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOGGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-439-3515
Mailing Address - Street 1:1515 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-1162
Mailing Address - Country:US
Mailing Address - Phone:740-439-3515
Mailing Address - Fax:740-432-6427
Practice Address - Street 1:1515 MAPLE DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-1162
Practice Address - Country:US
Practice Address - Phone:740-439-3515
Practice Address - Fax:740-432-6427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076860207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0528343Medicaid
OH0528343Medicaid