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Individual

STEVEN GOAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
445 S LANDMARK AVE, BLOOMINGTON, IN 47403-5004
(812) 353-3450
(812) 353-3451
Mailing address
PO BOX 1149, BLOOMINGTON, IN 47402-1149
(812) 353-3087

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01071896A
IN
2084P0800X
Psychiatry Physician
2004016667
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201149960
IN
Enumeration date
10/11/2006
Last updated
11/14/2014
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