Individual
AMANDA LYNN GOODNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500 N 12TH ST, WEST COLUMBIA, SC 29169-6502
(803) 217-0415
(803) 939-1650
Mailing address
PO BOX 3788, COLUMBIA, SC 29230-3788
(803) 733-5969
(803) 217-0026
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32741
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
327417
—
SC
Enumeration date
07/07/2010
Last updated
11/01/2013
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