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Individual

DR. MICHAEL WILLIAM GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
979 E 3RD ST, SUITE C0630, CHATTANOOGA, TN 37403-2136
(423) 267-5677
(423) 267-6179
Mailing address
979 E 3RD ST, SUITE C0630, CHATTANOOGA, TN 37403-2136
(423) 267-5677
(423) 267-6179

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
015401
TN
207RG0100X
Gastroenterology Physician
026122
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100005904
RAILROAD MEDICARE
TN
01
192613
BLUE CROSS BLUE SHIELD OF
TN
05
3006410
TN
01
621553135003
CIGNA
TN
01
GT23445
UNITED HEALTH CARE
Enumeration date
08/11/2005
Last updated
09/03/2024
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