Individual
DR. MARK ALLEN GOODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
114 WELTON WAY STE A, MOORESVILLE, NC 28117-9251
(704) 664-5766
(704) 664-9311
Mailing address
114 WELTON WAY, SUITE A, MOORESVILLE, NC 28117-9163
(704) 664-5766
(704) 664-9311
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
9701373
NC
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
97-01373
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2244486B
MEDICARE INDIVIDUAL
NC
05
—
790243U
—
NC
01
—
G54400
UPIN
NC
Enumeration date
01/05/2006
Last updated
02/22/2024
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