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Individual
DR. WALLACE HANNA GOOD JR.
Active
Individual
DR. WALLACE HANNA GOOD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
042-0006834
VT
207L00000X
Anesthesiology Physician
144954
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006375
—
VT
05
—
01053034
—
NY
01
—
06375
BLUE SHIELD
VT
01
—
86095
MVP
VT
Enumeration date
07/10/2006
Last updated
07/08/2007
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