MEDICARE: HALLE ROCHELLE GOODWIN 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
1	207V00000X	Obstetrics & Gynecology Physician	303347	NC
2	207VX0201X	Gynecologic Oncology Physician	1427636984	NC

General Provider Information

NPI Number	:	1427636984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALLE ROCHELLE GOODWIN MD

Provider Business Mailing Address
First Line	:	1012 MARGARET BROWN ST
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28202-1146
Country	:	US
Telephone Number	:	941-321-7936
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 MOREHEAD MEDICAL DR STE 2100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2991
Country	:	US
Telephone Number	:	980-442-2200
Fax Number	:	704-446-1551

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

Provider Enumeration Date	:	03/29/2021
Last Update Date	:	02/17/2026

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