MEDICARE: DR. MICHAEL GOODIN

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	163W00000X	Registered Nurse	440916	OH
2	367500000X	Certified Registered Nurse Anesthetist	0021346	OH

General Provider Information

NPI Number	:	1770208902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL GOODIN

Provider Business Mailing Address
First Line	:	9856 DELTONA DR
Second Line	:
City	:	NEW MIDDLETOWN
State	:	OH
Zip	:	44442-9796
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-1006
Country	:	US
Telephone Number	:	216-444-2200
Fax Number	:

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

Provider Enumeration Date	:	10/10/2022
Last Update Date	:	06/21/2025

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Directions to “ DR. MICHAEL GOODIN ” Practice Location

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