Individual
EUNICE K. GOODEMOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18101 OAKWOOD BLVD, DEARBORN, MI 48124-4089
(313) 593-7000
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1865
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601008320
MI
363AS0400X
Surgical Physician Assistant
C0006214
MD
Other
Enumeration date
09/22/2016
Last updated
09/19/2023
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