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General NPI Number Information
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NPI Number | 1962500694
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Entity Type | Individual
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Provider Name | PATRICK B GOODMAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 2424 32ND AVE S STE 202
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City | GRAND FORKS
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State | ND
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Zip | 58201-6510
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Country | US
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Telephone | 701-746-6336
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Fax | 701-772-1030
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Provider Business Mailing Address
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Address Line | 2424 32ND AVE S STE 202
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City | GRAND FORKS
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State | ND
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Zip | 58201-6510
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Country | US
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Telephone | 701-746-6336
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Fax | 701-772-1030
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 6215
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License Number State | ND
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