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General NPI Number Information
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NPI Number | 1447559927
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Entity Type | Individual
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Provider Name | ERIC ROBERT GOODLEV MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 1330 POWELL ST STE 100
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City | NORRISTOWN
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State | PA
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Zip | 19401-3358
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Country | US
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Telephone | 484-622-7618
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Fax | 610-270-0163
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Provider Business Mailing Address
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Address Line | PO BOX 789967
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City | PHILADELPHIA
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State | PA
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Zip | 19178-9967
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Country | US
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Telephone | 484-622-7395
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Fax | 484-622-7399
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | MD460516
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License Number State | PA
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