Individual
DR. CARMEL LYNN GOUDZWAARD
Active
Individual
DR. CARMEL LYNN GOUDZWAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036123732
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036123732
IL
207RP1001X
Pulmonary Disease Physician
036123732
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123732
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147112
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
P01144148
RAILROAD MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
08/18/2008
Last updated
04/09/2013
Update your record
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