Individual
DR. SEAN MICHAEL GOUDSWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
187 S ROUTE 73 STE B, HAMMONTON, NJ 08037-9432
(609) 567-2101
(609) 704-9351
Mailing address
187 S ROUTE 73 STE B, HAMMONTON, NJ 08037-9432
(609) 567-2101
(609) 704-9351
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB05566900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0455091
MEDICAID GROUP
NJ
01
—
381020
MEDICARE GROUP
NJ
05
—
5281601
—
NJ
Enumeration date
05/23/2006
Last updated
07/21/2022
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