Susan J Goddard
Pediatrician Pediatric Emergency Physician
2525 Chicago Ave
Minneapolis
, Minnesota 55404-4518
Susan J Goddard
Pediatrician Pediatric Emergency Physician
2525 Chicago Ave
Minneapolis
, Minnesota 55404-4518
(651) 905-1146
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About
Features
Specialties
- Pediatric Emergency Physician
- Pediatrician
Languages spoken
- English
Location
First Address
- Susan J Goddard
- 11468 Avery Dr
- Inver Grove Heights, MN
- Zip : 55077-5483
- Phone : (651) 905-1146
Second Address
- Susan J Goddard
- 2525 Chicago Ave
- Minneapolis, MN
- Zip : 55404-4518
- Phone : (651) 220-6912
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PP0204X | Pediatric Emergency Physician | 34818 | MN |
| N | 208000000X | Pediatrician | 34818 | MN |
National Provider Identifier
| NPI | 1245215201 |
|---|---|
| Provider Name | Susan J Goddard |
| First Address | Inver Grove Heights, MN 55077-5483 |
| Second Address | Minneapolis, MN 55404-4518 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/12/2005 |
| Last Update Date | 10/11/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 858102 | (05) | AZ |
| G70945 | (02) |
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.