Individual
DAVID DANIEL GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 EAST MAIN STREET, CUYUNA REGIONAL MEDICAL CENTER, CROSBY, MN 56441-1691
(218) 546-7000
(218) 545-4456
Mailing address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
(218) 564-4400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35394
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101128
MEDICA
—
01
—
080057485
RR MEDICARE
—
01
—
089005707
MEDICARE
—
01
—
120972C750
UCARE
—
05
—
216008100
—
MN
01
—
236086
AMERICAS PPO
—
01
—
5053184
AETNA
—
01
—
6T357GO
BCBS
—
01
—
E035
TRICARE
—
01
—
HP24212
HEALTHPARTNERS
—
01
—
NS1141008751
PREFERRED ONE
—
Enumeration date
12/08/2005
Last updated
11/19/2020
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