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Individual

MR. CHARLES DRU GOODWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 E MAIN ST, STE 102, COLUMBUS, OH 43215-5369
(614) 321-3701
(614) 259-6072
Mailing address
500 E MAIN ST, STE 102, COLUMBUS, OH 43215-5369
(614) 321-3701
(614) 259-6072

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35040957
OH
2086S0120X
Pediatric Surgery Physician
35040957
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0336121
OH
Enumeration date
09/22/2006
Last updated
12/17/2017
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