ERICH A WIDEMARK PHD, FNP-BC
NPI 1669468260
Nurse Practitioner - Family in Goodyear, AZ

Q: What is Erich Widemark's NPI number?

The NPI number for Erich Widemark is 1669468260. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Q: What is Erich Widemark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Erich Widemark was last updated on November 19, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 20, 2005

14415 W MCDOWELL RD, GOODYEAR, GOODYEAR, AZ 85395(623) 512-4190(623) 512-4194 Get Directions Write a Review

NPPES record last updated: November 19, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Erich A Widemark Phd, Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ERICH A WIDEMARK PHD, FNP-BC (NPI 1669468260) is an individual family provider in Goodyear, Arizona, licensed in Arizona (083736) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1669468260

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameERICH A WIDEMARKCredential: PHD, FNP-BC

Location Address14415 W MCDOWELL RD, GOODYEARGoodyear, AZ 85395-2521

Mailing Address14415 W Mcdowell Rd, Suite D2Goodyear, AZ 85395-2521 · (623) 512-4190 · Fax (623) 512-4194

Phone(623) 512-4190

Fax(623) 512-4194

Sole ProprietorNo

Enumeration DateSeptember 20, 2005

Last NPPES UpdateNovember 19, 2009

✔ NPI 1669468260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · 083736

14415 W MCDOWELL RD, Goodyear, AZ 85395

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Other Identifiers 4

Medicare ID-Type Unspecified10299AZ

Medicaid630344001AZ

Medicaid630344AZ

Medicare UPINS95697

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRINEET K TUNG MD

Internal Medicine

14415 W MCDOWELL RD, SUITE D102
GOODYEAR, AZ 85395

Maricopa County (623) 512-4190

ANN M VOGHT PA-C

Physician Assistant (Medical)

14415 W MCDOWELL RD, SUITE D102
GOODYEAR, AZ 85395

Maricopa County (602) 633-3848

NAVTEJ S. TUNG M.D.

Anesthesiology (Pain Medicine)

14415 W MCDOWELL RD, SUITE D102
GOODYEAR, AZ 85395

Maricopa County (623) 512-4190

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Erich Widemark's NPI number?

The NPI number for Erich Widemark is 1669468260. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Where is Erich Widemark located?

Erich Widemark practices at 14415 W Mcdowell Rd Goodyear, Goodyear, AZ 85395. The listed phone number is (623) 512-4190.

What is Erich Widemark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Erich Widemark was last updated on November 19, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.