Goodman, Gary R
Goodman, Gary R is an individual health care provider with primary practice located at 22250 Providence Dr Ste 606 , Southfield MI 48075-6214. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Goodman, Gary R can be contacted via phone (248) 443-1281.Contact Information
Primary practice address
22250 Providence Dr Ste 606
Southfield MI 48075-6214
Phone: (248) 443-1281
Fax: (248) 443-1411
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 4301044225 | Michigan |
Profile Details
| NPI number | 1982669024 |
|---|---|
| LBN Legal business name | Goodman, Gary R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2006 |
| Last updated | Aug 26th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982669024 | NPPES |
| Michigan | MEDICAID | 10 3282495 |
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