Individual
DR. GREGORY JOHN GOODWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 CARNIE BLVD, SUITE B-5, VOORHEES, NJ 08043-4512
(856) 751-0123
(856) 751-5650
Mailing address
1307 WHITE HORSE RD, SUITE A-102, VOORHEES, NJ 08043-2176
(856) 374-4031
(856) 232-9139
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA08081700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00332777
RAILROAD MEDICARE
—
05
—
0105287
—
NJ
01
—
11619019
CAQH
—
01
—
1281304
AETNA
—
01
—
1396272
UNITED HEALTHCARE
—
01
—
272755000
AMERIHEALTH
—
01
—
60025194
HORIZON NJ HEALTH
—
01
—
A3738029
OXFORD HEALTH
—
01
—
GO1869628
HIGHMARK PA BLUE SHIELD
—
Enumeration date
05/06/2006
Last updated
05/24/2012
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