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NPI Code Detail

MEDICARE: DAVID A GOODMAN M.D.

MEDICARE: DAVID A GOODMAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMD-032099-ENJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093717290
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID A GOODMAN M.D.
Provider Business Mailing Address
First Line : P.O. BOX 8500-5365
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19178-0001
Country : US
Telephone Number : 201-804-2800
Fax Number :
Provider Business Practice Location Address
First Line : 1200 OLD YORK RD
Second Line :
City : ABINGTON
State : PA
Zip : 19001-3720
Country : US
Telephone Number : 215-481-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 01/23/2013

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