Matthew B Goodfellow
Technician/Technologist
2633 11 Mile Rd Nw
Sparta
, Michigan 49345-9751
Matthew B Goodfellow
Technician/Technologist
2633 11 Mile Rd Nw
Sparta
, Michigan 49345-9751
(616) 773-8339
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About
Features
Specialties
- Technician/Technologist
Languages spoken
- English
Location
First Address
- Matthew B Goodfellow
- 2633 11 Mile Rd Nw
- Sparta, MI
- Zip : 49345-9751
- Phone : (616) 773-8339
Second Address
- Matthew B Goodfellow
- 2633 11 Mile Rd Nw
- Sparta, MI
- Zip : 49345-9751
- Phone : (616) 773-8339
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 156F00000X | Technician/Technologist |
National Provider Identifier
| NPI | 1023775459 |
|---|---|
| Provider Name | Matthew B Goodfellow |
| First Address | Sparta, MI 49345-9751 |
| Second Address | Sparta, MI 49345-9751 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/11/2021 |
| Last Update Date | 19/11/2021 |
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.