Individual
NICHOLAS MATTHEW GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
80 SEYMOUR ST BLDG 502, HARTFORD, CT 06102-8000
(860) 972-0549
Mailing address
80 SEYMOUR ST, HARTFORD, CT 06102-8000
(860) 972-0549
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
78796
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2021
Last updated
09/06/2024
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