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Individual

DAVID MARKUS GOODRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1218 N MAIN ST, PUEBLO, CO 81003-2828
(719) 543-7877
(719) 543-7882
Mailing address
1218 N MAIN ST, PUEBLO, CO 81003-2828
(719) 543-7877
(719) 543-7882

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN12279
TN
367500000X
Certified Registered Nurse Anesthetist
RN99907
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3636921
TN
01
4137595
BCBS OF TN
TN
01
P00371821
RAILROAD MEDICARE
Enumeration date
10/24/2006
Last updated
06/09/2011
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