Goddard, Susan J
Goddard, Susan J is an individual health care provider with primary practice located at 2525 Chicago Ave , Minneapolis MN 55404-4518. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Goddard, Susan J can be contacted via phone (651) 220-6912.Contact Information
Primary practice address
2525 Chicago Ave
Minneapolis MN 55404-4518
Phone: (651) 220-6912
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | 34818 | Minnesota |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 34818 | Minnesota |
Profile Details
| NPI number | 1245215201 |
|---|---|
| LBN Legal business name | Goddard, Susan J |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2005 |
| Last updated | Nov 10th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245215201 | NPPES |
| Arizona | MEDICAID | 858102 |
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