Individual
DR. ZACHARY AVITAL GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6642 CLAYTON RD # 278, SAINT LOUIS, MO 63117-1602
(000) 000-0000
Mailing address
6642 CLAYTON RD # 278, SAINT LOUIS, MO 63117-1602
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2018042200
MO
Other
Enumeration date
06/20/2017
Last updated
01/30/2019
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