Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OH3580067 | OH |
N | 111NI0900X | Internist | OH3580067 | OH |
Y | 207RI0200X | Infectious Disease | OH3580067 | OH |
NPI | 1023073962 |
---|---|
Provider Name | Dr. Richard Paul Goodman |
First Address | Cincinnati, OH 45236-2725 |
Second Address | Cincinnati, OH 45236-2725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 24/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013066281 | NPI GROUP (01) | OH |
2292086 | (05) | OH |
G11604 | (02) | OH |
IN9310411 | MEDICARE GROUP (01) | OH |