Dr. Gary M Goodman
Pediatrician Pediatric Allergist
1 Childrens Pl
Saint Louis
, Missouri 63110-1002
Dr. Gary M Goodman
Pediatrician Pediatric Allergist
1 Childrens Pl
Saint Louis
, Missouri 63110-1002
(314) 569-3277
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About
Features
Specialties
- Pediatrician
- Pediatric Allergist
Languages spoken
- English
Location
First Address
- Dr. Gary M Goodman
- 456 N New Ballas Rd Ste 129
- Saint Louis, MO
- Zip : 63141-6812
- Fax : (314) 569-3277
- Phone : (314) 569-1881
Second Address
- Dr. Gary M Goodman
- 1 Childrens Pl
- Saint Louis, MO
- Zip : 63110-1002
- Fax : (314) 454-2515
- Phone : (314) 454-2694
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | 102527 | MO |
| Y | 2080P0201X | Pediatric Allergist | 102527 | MO |
National Provider Identifier
| NPI | 1811999485 |
|---|---|
| Provider Name | Dr. Gary M Goodman |
| First Address | Saint Louis, MO 63141-6812 |
| Second Address | Saint Louis, MO 63110-1002 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/08/2005 |
| Last Update Date | 19/02/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 204643001 | (05) | MO |
| ENROLLED | (05) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.