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NPI Code Detail

MEDICARE: DR. MICHAEL D GOODRICH MD

MEDICARE:  DR. MICHAEL D GOODRICH  MD
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
1207L00000XAnesthesiology Physician0101840400VA

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 : 1134122930
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL D GOODRICH MD
Provider Business Mailing Address
First Line : PO BOX 3605
Second Line :
City : RADFORD
State : VA
Zip : 24143-3605
Country : US
Telephone Number : 866-224-2413
Fax Number : 540-776-0699
Provider Business Practice Location Address
First Line : 2900 LAMB CIR
Second Line : STE 340
City : CHRISTIANSBURG
State : VA
Zip : 24073-6344
Country : US
Telephone Number : 540-731-1898
Fax Number : 540-639-5426
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 01/27/2010

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Directions to “ DR. MICHAEL D GOODRICH MD” Practice Location

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