Individual
ROBERT W GODLEY II
Active
Individual
ROBERT W GODLEY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01081921A
IN
390200000X
Student in an Organized Health Care Education/Training Program
4301100740
MI
390200000X
Student in an Organized Health Care Education/Training Program
BP10052864
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300026003
—
IN
01
—
P02559041
RR MEDICARE
IN
Enumeration date
06/19/2012
Last updated
06/11/2021
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