Individual
DR. MARK JAMES GOETHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 CAMPUS RIDGE DR, MIDLAND, MI 48640-6112
(989) 832-0323
(989) 631-0886
Mailing address
4401 CAMPUS RIDGE DR, MIDLAND, MI 48640
(989) 832-0323
(989) 631-0886
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301405876
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005601332
BCBS
MI
05
—
2971771
—
MI
01
—
P72856
BCN
MI
Enumeration date
07/24/2006
Last updated
09/25/2017
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