MEDICARE: DONNA M GOOD DO

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	207Q00000X	Family Medicine Physician	0102050229	VA

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	:	1679577217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA M GOOD DO

Provider Business Mailing Address
First Line	:	PO BOX 457
Second Line	:	5 E ALVON ROAD, SUITE 7
City	:	WHITE SULPHUR SPRINGS
State	:	WV
Zip	:	24986-2373
Country	:	US
Telephone Number	:	304-536-5030
Fax Number	:	304-536-5031

Provider Business Practice Location Address
First Line	:	2419 VALLEY RIDGE RD
Second Line	:
City	:	COVINGTON
State	:	VA
Zip	:	24426-6381
Country	:	US
Telephone Number	:	540-863-8736
Fax Number	:	540-863-8750

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	10/15/2011

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Directions to “ DONNA M GOOD DO” Practice Location

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