Individual
DR. TERESA DUDEK GOODPASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3051 6TH STREET, MARIANNA, FL 32446-1933
(850) 482-0017
Mailing address
3051 6TH STREET, MARIANNA, FL 32446-1933
(850) 482-0017
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35-06-3092-D
OH
208600000X
Surgery Physician
Primary
ME98349
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279095500
—
FL
Enumeration date
09/20/2005
Last updated
01/22/2010
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