Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 2021-01786 | NC |
NPI | 1073044624 |
---|---|
Provider Name | Diamond Marie Goodwin |
First Address | Morrisville, NC 27560-5491 |
Second Address | Chapel Hill, NC 27514-4220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2017 |
Last Update Date | 18/08/2021 |