Goodwin, Brian Lawrence

Goodwin, Brian Lawrence is an sole proprietor health care provider with primary practice located at 4737 24 Mile Rd Suite 2, Shelby Township MI 48316-3148. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Goodwin, Brian Lawrence can be contacted via phone (248) 651-0008.

Contact Information

Primary practice address
4737 24 Mile Rd Suite 2 Shelby Township MI 48316-3148
Phone: (248) 651-0008
Fax: (248) 651-6988
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 5901400156 Michigan

Profile Details

NPI number 1124027321
LBN Legal business name Goodwin, Brian Lawrence
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2005
Last updated Apr 21st, 2016 - about 9 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 1124027321 NPPES
Michigan MEDICAID 1906797
Michigan Other 485505278
Michigan Other 4661520001

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