Healthcare Provider Details

I. General information

NPI: 1326092909
Provider Name (Legal Business Name): ANN MARIE GOODING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 E 19TH AVE
DENVER CO
80218-1211
US

IV. Provider business mailing address

106 MC INTYRE CIR
GOLDEN CO
80401-5064
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-7786
  • Fax: 303-839-7649
Mailing address:
  • Phone: 303-384-0448
  • Fax: 303-384-0447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number36322
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: