Individual
DR. THOMAS L GOODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5900 BYRON CENTER AVE SW, METRO HEALTH - HOSPITAL, WYOMING, MI 49519-9606
(616) 808-3944
(616) 808-3948
Mailing address
400 ANN ST NW, SUITE 209, GRAND RAPIDS, MI 49504-2052
(616) 808-3944
(616) 808-3948
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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