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Individual

RICHARD L GOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9660 WICKER AVE, ST JOHN, IN 46373-9487
(219) 365-1166
(219) 365-8852
Mailing address
9660 WICKER AVE, ST JOHN, IN 46373-9487
(219) 365-1166
(219) 365-8852

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027057
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000241329
ANTHEM BCBS
IN
01
080191621
MEDICARE RAILROAD
IN
05
100157680A
IN
Enumeration date
07/20/2005
Last updated
06/17/2010
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