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NPI Code Detail

MEDICARE: DR. MICHAEL GOODMAN MD, MPH

MEDICARE: DR. MICHAEL GOODMAN MD, MPH
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
1208000000XPediatrics Physician056716GA
22083P0901XPublic Health & General Preventive Medicine Physician056716GA

General Provider Information

NPI Number : 1710197520
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL GOODMAN MD, MPH
Provider Business Mailing Address
First Line : 1782 VICKERS CIR
Second Line :
City : DECATUR
State : GA
Zip : 30030-1000
Country : US
Telephone Number : 404-909-5155
Fax Number : 404-727-8737
Provider Business Practice Location Address
First Line : 1518 CLIFTON RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-4201
Country : US
Telephone Number : 404-727-2734
Fax Number : 404-727-8737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 10/21/2021

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Directions to “ DR. MICHAEL GOODMAN MD, MPH” Practice Location

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