Individual
BONNIE J GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
137 MEDICAL LANE, POLLOCKSVILLE, NC 28573
(252) 633-1010
(252) 224-3071
Mailing address
PO BOX 896206, CHARLOTTE, NC 28289-6206
(252) 633-1010
(252) 224-3071
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
27049
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36266
BLUE CROSS
NC
05
—
8936266
—
NC
Enumeration date
08/25/2005
Last updated
03/17/2017
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