Individual
KEELY B GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1031 W WILLIAMS ST, SUITE106, APEX, NC 27502-3955
(919) 363-0190
(919) 363-0195
Mailing address
1031 W WILLIAMS ST, SUITE106, APEX, NC 27502-3955
(919) 363-0190
(919) 363-0195
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200200328
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132RU
BCBS
NC
01
—
132RU
BCBS NC
—
05
—
5912910
—
NC
01
—
7154477
AETNA
—
05
—
89132RU
—
NC
Enumeration date
07/07/2006
Last updated
03/27/2013
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