Individual
PAUL GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-4103
Mailing address
3601 W 13 MILE RD, 400-FSC/PCS, ROYAL OAK, MI 48073-6712
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301024253
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1577901
—
MI
Enumeration date
03/24/2006
Last updated
07/08/2007
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