Individual
MARK D. GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1319 LEAVENWORTH ST, OMAHA, NE 68102-3215
(402) 717-0420
(402) 717-6042
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
(402) 398-6254
(402) 829-8513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17235
NE
Other
Enumeration date
08/29/2006
Last updated
11/09/2016
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