Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 35.089515 | OH |
N | 208600000X | Surgeon | 35.089515 | OH |
N | 2086S0102X | Surgical Critical Care | 35089515 | OH |
Y | 2086S0127X | Trauma Surgeon | 35089515 | OH |
NPI | 1265648794 |
---|---|
Provider Name | Dr. Michael D Goodman |
First Address | Cincinnati, OH 45263-6256 |
Second Address | Cincinnati, OH 45219-2364 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 09/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0080809 | (05) | OH |