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NPI Code Detail

MEDICARE: DR. TERRENCE LYNN GOODMAN MD

MEDICARE: DR. TERRENCE LYNN GOODMAN MD
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
1207R00000XInternal Medicine Physician22920NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
236224OTHERNCBCBS OF NC

General Provider Information

NPI Number : 1124022454
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRENCE LYNN GOODMAN MD
Provider Business Mailing Address
First Line : 306 MEDICAL PARK CT
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-4346
Country : US
Telephone Number : 252-247-2013
Fax Number : 252-247-7299
Provider Business Practice Location Address
First Line : 306 MEDICAL PARK CT
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-4346
Country : US
Telephone Number : 252-247-2013
Fax Number : 252-247-7299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 11/30/2007

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