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Individual

MR. PAUL GOODMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5711 SARVIS AVE, SUITE 402, RIVERDALE, MD 20737-1394
(301) 277-4844
(301) 927-3221
Mailing address
5711 SARVIS AVE, SUITE 402, RIVERDALE, MD 20737-1394
(301) 277-4844
(301) 927-3221

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D79841
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D79841
MEDICAL LICENSE
MD
Enumeration date
04/06/2011
Last updated
07/16/2015
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