Individual
EVAN J GOODMAN
Active
Individual
EVAN J GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35-061353
OH
207LA0401X
Addiction Medicine (Anesthesiology) Physician
35-061353
OH
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
35-061353
OH
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
35-061353
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
35-061353
OH
207LP3000X
Pediatric Anesthesiology Physician
35-061353
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000516036
ANTHEM
OH
01
—
000000221425
UNISON
OH
01
—
0583328
BCMH
OH
05
—
0827823
—
OH
01
—
363570
WELLCARE MEDICAID
OH
01
—
4202708
AETNA
OH
01
—
50028773
RAILROAD MEDICARE
OH
01
—
744955
BUCKEYE MEDICAID
OH
01
—
P00420566
MEDICARE RAILROAD
OH
Enumeration date
07/24/2006
Last updated
08/18/2010
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