Individual
MICHAEL H. GOODYEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3998 RED LION RD, EMERGENCY DEPARTMENT, PHILADELPHIA, PA 19114-1436
(215) 612-4000
(215) 807-8235
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-0001
(215) 807-8000
(215) 807-8235
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS010114L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017569670004
—
PA
05
—
0017569670005
—
PA
05
—
0017569670006
—
PA
01
—
01756967-02
AMERICHOICE- TORRES
PA
01
—
01756967-03
AMERICHOICE - BUCKS
PA
01
—
01756967-04
AMERICHOICE- FRANKFORD
PA
01
—
0326345
CIGNA
PA
01
—
0454368000
KEYSTONE IBC
PA
01
—
07645
HEALTH PARTNERS
PA
01
—
1096440
KEYSTONE MERCY
PA
01
—
20045132
AMERIHEALTH MERCY
PA
01
—
452729
AETNA CONTRACT
PA
01
—
698433
PERSONAL CHOICE
PA
01
—
930114018
RAILROAD MEDICARE
PA
Enumeration date
07/13/2006
Last updated
07/12/2007
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