Goddard, Susan J

Goddard, Susan J is an individual health care provider with primary practice located at 2525 Chicago Ave , Minneapolis MN 55404-4518. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Goddard, Susan J can be contacted via phone (651) 220-6912.

Contact Information

Primary practice address
2525 Chicago Ave Minneapolis MN 55404-4518
Phone: (651) 220-6912
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X 34818 Minnesota
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 34818 Minnesota

Profile Details

NPI number 1245215201
LBN Legal business name Goddard, Susan J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Nov 10th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245215201 NPPES
Arizona MEDICAID 858102

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