Individual
MARY E GOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9625 RED ARROW HWY, BRIDGMAN, MI 49106-9559
(269) 465-6050
(269) 465-3134
Mailing address
9625 RED ARROW HWY, BRIDGMAN, MI 49106-9559
(269) 465-6050
(269) 465-3134
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002600
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970016336
RAILROAD MEDICARE
MI
Enumeration date
06/30/2006
Last updated
03/14/2013
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