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Individual

DR. SOPHIA D GOODRIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2500 HOSPITAL BLVD STE 290, ROSWELL, GA 30076
(470) 956-4230
Mailing address
2500 HOSPITAL BLVD STE 290, ROSWELL, GA 30076-4918
(470) 956-4230

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
52077
KY
208800000X
Urology Physician
Primary
82831
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100580160
KY
Enumeration date
05/15/2012
Last updated
06/10/2019
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