Individual
DR. ANDREW JACKSON GOODWIN IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 COLCHESTER AVE, FLETCHER ALLEN HEALTH CARE, DEPARTMENT OF PATHOLOGY, BURLINGTON, VT 05401-1473
(802) 847-0392
Mailing address
22 BILODEAU CT, BURLINGTON, VT 05401-1518
(802) 734-1447
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
060-0003057
VT
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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