Individual
DR. ROBERT CLARE GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1726 ELLINGTON RD, SOUTH WINDSOR, CT 06074-2739
(860) 644-9191
(860) 644-9191
Mailing address
1726 ELLINGTON RD, SOUTH WINDSOR, CT 06074-2739
(860) 644-9191
(860) 644-9191
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16361
CT
2084P0800X
Psychiatry Physician
016361
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010016361CT01
NON-PAR ANTHEM ID
CT
Enumeration date
03/18/2007
Last updated
10/31/2013
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