MEDICARE: DONALD B GOODFELLOW 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	207X00000X	Orthopaedic Surgery Physician	35-042252	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00011035	OTHER	OH	RAILROAD MEDICARE
5	P00385113	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	363569	OTHER	OH	WELLCARE
3	738055	OTHER	OH	BUCKEYE
6	000000206624	OTHER	OH	UNISON
7	000000503676	OTHER		ANTHEM
8	4007304	OTHER		AETNA

General Provider Information

NPI Number	:	1740209196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD B GOODFELLOW MD

Provider Business Mailing Address
First Line	:	20800 HARVARD RD
Second Line	:	2ND FLOOR
City	:	HIGHLAND HILLS
State	:	OH
Zip	:	44122-7249
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 S GREEN RD STE 27
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44121-4128
Country	:	US
Telephone Number	:	216-844-7200
Fax Number	:	216-291-3984

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	01/13/2021

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Directions to “ DONALD B GOODFELLOW MD” Practice Location

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