MEDICARE: CHRISTOPHER GOODRICH M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	MD190407	OR

General Provider Information

NPI Number	:	1346652831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER GOODRICH M.D.

Provider Business Mailing Address
First Line	:	5100 BUCKEYSTOWN PIKE STE 250
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21704-8344
Country	:	US
Telephone Number	:	646-863-1411
Fax Number	:	516-864-4618

Provider Business Practice Location Address
First Line	:	9428 BAYMEADOWS RD STE 502
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-7973
Country	:	US
Telephone Number	:	646-863-1411
Fax Number	:

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

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	10/17/2023

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Directions to “ CHRISTOPHER GOODRICH M.D.” Practice Location

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