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Individual

STEPHEN CHAS GOODWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CAA

Contact information

Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE STE 401, GREENVILLE, SC 29601-2842
(864) 522-8602

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
83
SC
367H00000X
Anesthesiologist Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NAN167
SC
Enumeration date
08/05/2019
Last updated
12/28/2021
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