Goodman, Gary R

Goodman, Gary R is an individual health care provider with primary practice located at 22250 Providence Dr Ste 606 , Southfield MI 48075-6214. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Goodman, Gary R can be contacted via phone (248) 443-1281.

Contact Information

Primary practice address
22250 Providence Dr Ste 606 Southfield MI 48075-6214
Phone: (248) 443-1281
Fax: (248) 443-1411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 4301044225 Michigan

Profile Details

NPI number 1982669024
LBN Legal business name Goodman, Gary R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Aug 26th, 2019 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982669024 NPPES
Michigan MEDICAID 10 3282495

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