Individual
MARK KIMBALL GODDARD
Active
Individual
MARK KIMBALL GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
293990-1205
UT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD00046412
WA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD26606
OR
207RP1001X
Pulmonary Disease Physician
293990-1205
UT
207RP1001X
Pulmonary Disease Physician
MD00046412
WA
207RP1001X
Pulmonary Disease Physician
MD26606
OR
Other
Enumeration date
10/20/2006
Last updated
01/21/2009
Update your record
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