Individual
FREDERICK K GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 MEDICAL PKWY, ANNAPOLIS, MD 21401-3280
(443) 481-1366
Mailing address
2001 MEDICAL PKWY, ANNAPOLIS, MD 21401-3280
(443) 481-1366
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D61498
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001498200
—
MD
01
—
60055702
BLUE SHIELD
MD
01
—
T2390016
GHI
DC
Enumeration date
08/18/2006
Last updated
09/18/2023
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