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General NPI Number Information
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NPI Number | 1669827358
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Entity Type | Individual
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Provider Name | ERIN GOODE D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/29/2016
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 3901 BEAUBIEN ST
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City | DETROIT
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State | MI
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Zip | 48201-2119
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Country | US
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Telephone | 313-745-5870
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Fax |
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Provider Business Mailing Address
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Address Line | 282 WASHINGTON ST
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City | HARTFORD
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State | CT
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Zip | 06106-3322
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Country | US
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Telephone | 860-837-9970
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Fax | 860-545-9159
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5101027042
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License Number State | MI
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