MEDICARE: MEREDITH OWEN GODWIN 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
1	2084P0800X	Psychiatry Physician	2009-01506	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1659571792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEREDITH OWEN GODWIN M.D.

Provider Business Mailing Address
First Line	:	2719 GRAVES DR. #19
Second Line	:	#19
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-4536
Country	:	US
Telephone Number	:	919-587-4051
Fax Number	:	919-580-1083

Provider Business Practice Location Address
First Line	:	2719 GRAVES DR. #19
Second Line	:	#19
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-4536
Country	:	US
Telephone Number	:	919-587-4051
Fax Number	:	919-580-1083

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	10/17/2022

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