Individual
DR. THOMAS L GOODELL
Active
Individual
DR. THOMAS L GOODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5101014480
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050D110480
BCBS
MI
05
—
4173010
—
MI
01
—
5410221
BCBS
MI
01
—
CE1952
RAILROAD MEDICARE GROUP #
MI
01
—
P00137306
RAILROAD MEDICARE
MI
01
—
TG014480
BCBS
MI
Enumeration date
04/11/2006
Last updated
04/02/2008
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