MEDICARE: MICAH GOODWIN APRN

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	363L00000X	Nurse Practitioner	R244861	MD

General Provider Information

NPI Number	:	1043083678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICAH GOODWIN APRN

Provider Business Mailing Address
First Line	:	1 OLYMPIC PL
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-4104
Country	:	US
Telephone Number	:	888-444-1374
Fax Number	:	410-584-5440

Provider Business Practice Location Address
First Line	:	1 OLYMPIC PL
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-4104
Country	:	US
Telephone Number	:	888-444-1378
Fax Number	:	410-584-5440

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

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	05/28/2026

Similar Medicare Providers

1578637294 — JOSEPH A ADAMS M.D.
Practice Location Address:

6701 N CHARLES ST , SUITE 4104
TOWSON, MD
21204-6808

Practice Phone: 410-231-3323
Practice Fax:

1801915079 — MRS. CARMEN R TUCKER-RICHARDSON M.A., CCC-SLP
Practice Location Address:

1 OLYMPIC PL
TOWSON, MD
21204-4104

Practice Phone: 443-579-4757
Practice Fax:

1245474063 — DR. FIDELIS CAROLINE DEFINE MD
Practice Location Address:

6701 N CHARLES ST , 4104
TOWSON, MD
21204-6808

Practice Phone: 410-227-7149
Practice Fax: 410-561-3911

1023368412 — PHOENIX SUPPORT SERVICES, LLC
Practice Location Address:

6701 N CHARLES ST , STE 4104
TOWSON, MD
21204-6808

Practice Phone: 410-714-0077
Practice Fax:

1336571223 — ROBERTA BRESLOW
Practice Location Address:

1 OLYMPIC PL STE 200 , TOWSON UNIVERSITY, SPEEC-LANGUAGE-HEARING CENTER
TOWSON, MD
21204-4104

Practice Phone: 410-704-3095
Practice Fax: 410-704-6303

1932531456 — CHRISTINA YEAGER PELATTI
Practice Location Address:

1 OLYMPIC PL , SUITE 200
TOWSON, MD
21204-4104

Practice Phone: 410-704-7302
Practice Fax: 410-704-6303

Directions to “ MICAH GOODWIN APRN” 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.