Individual
NEIL E. GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5500 FREDERICA RD UNIT 2208, ST SIMONS ISLAND, GA 31522-9703
(912) 268-4633
(888) 771-6577
Mailing address
23 CARRIAGE DR, ST SIMONS ISLAND, GA 31522-5457
(912) 230-2323
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
034143
GA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
034143
GA
2080A0000X
Pediatric Adolescent Medicine Physician
139707
FL
2080A0000X
Pediatric Adolescent Medicine Physician
269918
NY
2080A0000X
Pediatric Adolescent Medicine Physician
82230
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34143
MEDICAL LICENSE
GA
Enumeration date
08/10/2011
Last updated
02/26/2023
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