Goode, Mark D

Goode, Mark D is an individual health care provider with primary practice located at 22 Bramhall St , Portland ME 04102-3134. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Goode, Mark D can be contacted via phone (207) 662-2661.

Contact Information

Primary practice address
22 Bramhall St Portland ME 04102-3134
Phone: (207) 662-2661
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA001177 Maine

Profile Details

NPI number 1790018414
LBN Legal business name Goode, Mark D
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2009
Last updated Jan 10th, 2011 - about 15 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 1790018414 NPPES
New Hampshire MEDICAID 30338119
New Hampshire MEDICAID 435703099

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