Individual
MICHAEL J GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 239
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932433
—
AL
05
—
009942945
—
AL
01
—
051520055
BLUE CROSS
AL
01
—
051529670
BLUE CROSS
AL
Enumeration date
06/22/2006
Last updated
03/16/2013
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