Individual
AMANDA GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
887 CONGRESS ST STE 100, PORTLAND, ME 04102-3100
(207) 662-5522
(207) 662-5524
Mailing address
35 NUTTER WAY, SCARBOROUGH, ME 04074-8715
(781) 608-3339
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
247365
MA
208000000X
Pediatrics Physician
60019802
WA
2080P0208X
Pediatric Infectious Diseases Physician
Primary
MD22632
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/19/2007
Last updated
01/09/2019
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