Individual
MARK ADAM GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2050 OAK MOUNTAIN DR, SUITE 7, PELHAM, AL 35124-1368
(205) 621-5780
(205) 621-9780
Mailing address
2050 OAK MOUNTAIN DR, SUITE 7, PELHAM, AL 35124-1368
(205) 621-5780
(205) 621-9780
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
00020013
AL
2085R0202X
Diagnostic Radiology Physician
049537
GA
2085R0202X
Diagnostic Radiology Physician
4301058407
MI
2085R0202X
Diagnostic Radiology Physician
ME81700
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051533737
BLUE CROSS
AL
Enumeration date
05/17/2006
Last updated
02/19/2009
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