MEDICARE: MATTHEW B GOODFELLOW CDT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156F00000X	Technician/Technologist

General Provider Information

NPI Number	:	1023775459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW B GOODFELLOW CDT

Provider Business Mailing Address
First Line	:	2633 11 MILE RD NW
Second Line	:
City	:	SPARTA
State	:	MI
Zip	:	49345-9751
Country	:	US
Telephone Number	:	616-773-8339
Fax Number	:

Provider Business Practice Location Address
First Line	:	2633 11 MILE RD NW
Second Line	:
City	:	SPARTA
State	:	MI
Zip	:	49345-9751
Country	:	US
Telephone Number	:	616-773-8339
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2021
Last Update Date	:	11/19/2021

Similar Medicare Providers

1245769744 — TRINITY HEALTH - MICHIGAN
Practice Location Address:

475 S STATE ST
SPARTA, MI
49345-1549

Practice Phone: 616-685-1300
Practice Fax: 616-887-5989

1174482525 — CHRISTINA MANGOLD INC
Practice Location Address:

220 E DIVISION ST
SPARTA, MI
49345-1328

Practice Phone: 231-729-1384
Practice Fax:

1669127700 — CHRISTINA NICOLE MANGOLD
Practice Location Address:

220 E DIVISION ST
SPARTA, MI
49345-1328

Practice Phone: 231-729-1384
Practice Fax:

1598769242 — SHARON L SIEFERT M.D
Practice Location Address:

2111 12 MILE RD NW
SPARTA, MI
49345-9754

Practice Phone: 616-391-8470
Practice Fax: 616-391-8495

1841294592 — JAMES P RANTA DO, M.S.
Practice Location Address:

2111 12 MILE RD NW
SPARTA, MI
49345-9754

Practice Phone: 616-391-8470
Practice Fax: 616-391-8495

1467456103 — BRENDA S ZOOK MD
Practice Location Address:

2111 12 MILE RD NW
SPARTA, MI
49345-9754

Practice Phone: 616-391-8470
Practice Fax: 616-391-8495

Directions to “ MATTHEW B GOODFELLOW CDT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.