Gary R Goodman, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

4301044225 Issued in MI

Practice address

22250 Providence Dr Ste 606
Southfield, MI 48075-6214

Phone

(248) 443-1281

Fax

(248) 443-1411

NPI assigned

Apr 20, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: garygoodman@ctsi.allscriptsdirect.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1982669024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON ST STE 203",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432967",
            "telephone_number": "586-493-9229",
            "fax_number": "586-493-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 606",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756214",
            "telephone_number": "248-443-1281",
            "fax_number": "248-443-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "GARY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301044225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10 3282495",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Good Health and Aging Well on Purpose Counseling and Coaching Center P
• Ella Good
• Sandra Ann Goodall, LLP
• Robert Lawrence Goode, DDS
• Jacqueline Venora Goodgame, LPN
• Madison Leigh Goodman, PA-C
• Peter M Goodman, M.D.
• Robert Goodman, DMD
• Theresa Goodrich
• Goods & Services G & S LLC

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.