Individual
DR. MARK D. GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
EMILE 42ND ST, OMAHA, NE 68198-3075
(402) 559-7200
(402) 559-9344
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-2700
(402) 559-3944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23319
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23319
NE STATE LICENSE
NE
Enumeration date
09/14/2005
Last updated
10/22/2013
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