Individual
DR. KALIE MARIE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
48 CENTENNIAL WAY, GREENVILLE, SC 29605-4662
(864) 522-8000
(864) 522-8005
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
13271767-1205
UT
208600000X
Surgery Physician
Primary
92979
SC
208600000X
Surgery Physician
LL52459
SC
208C00000X
Colon & Rectal Surgery Physician
13271767-1205
UT
Other
Enumeration date
05/29/2018
Last updated
10/01/2024
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