# ANDREA D. GOODWIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1285616870
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 17693 | MS | — |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | 17693 | MS | Yes |

## Other

- **Enumeration date:** 11/18/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00755091 | — | MS |
| 01 | — | P00071956 | RAILROAD MEDICARE | — |