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General NPI Number Information
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NPI Number | 1497886402
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Entity Type | Individual
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Provider Name | MICHAEL PAUL GOOD OD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 12/08/2008
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Provider Practice Location Address
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Address Line | 33398 WALKER RD STE. B
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City | AVON LAKE
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State | OH
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Zip | 44012-1496
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Country | US
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Telephone | 440-933-3214
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Fax | 440-933-4924
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Provider Business Mailing Address
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Address Line | 33398 WALKER RD STE. B
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City | AVON LAKE
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State | OH
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Zip | 44012-1496
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Country | US
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Telephone | 440-933-3214
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Fax | 440-933-4924
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4281T463
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License Number State | OH
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