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Individual
STANLEY M GODSHALL
Active
Individual
STANLEY M GODSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD012425E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006875700001
—
PA
01
—
01350202
CAPITAL BLUE CROSS
PA
01
—
127132
HIGHMARK BLUE SHIELD
PA
01
—
17534 S101
GEISINGER HEALTH PLAN
PA
01
—
4662913
AETNA NON-HMO
PA
01
—
577392
AETNA HMO
PA
01
—
B37441
HEALTH ASSURANCE
PA
01
—
P002667
GATEWAY HEALTH PLAN
PA
Enumeration date
01/19/2006
Last updated
10/25/2007
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