Individual
MICHAEL J GODARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
615 RIDGE RD, ROXBORO, NC 27573-4629
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 30727, CHARLOTTE, NC 28230-0727
(843) 237-3378
(843) 237-5073
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9900054
NC
207Q00000X
Family Medicine Physician
9900054
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223C
BCBS
NC
05
—
891223C
—
NC
01
—
930100502
RAILROAD
NC
05
—
Q00054
—
SC
Enumeration date
04/07/2006
Last updated
08/28/2013
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