Individual
BRIAN GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 E NICOLLET BLVD, FAIRVIEW RIDGES HOSPITAL, BURNSVILLE, MN 55337
(952) 892-2021
(952) 892-2670
Mailing address
7301 OHMS LANE, SUITE 650, EDINA, MN 55439
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
45985
MN
207P00000X
Emergency Medicine Physician
55046-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303674000
—
MN
01
—
45985
MEDICAL LICENSE
MN
Enumeration date
03/07/2006
Last updated
04/03/2024
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