Individual
PETER DAVID GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
580 S LOOP RD, EDGEWOOD, KY 41017
(859) 301-6000
(859) 301-6010
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-6099
(859) 301-6010
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16868
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0255745
—
OH
05
—
200916660
—
IN
05
—
64055916
—
KY
Enumeration date
08/02/2005
Last updated
09/13/2018
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