Individual
REBECCA GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 E MARSHALL ST, BOX 908401, RICHMOND, VA 23298-5051
(208) 850-0881
Mailing address
1250 E MARSHALL ST, BOX 908401, RICHMOND, VA 23298-5051
(208) 850-0881
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101275784
VA
207R00000X
Internal Medicine Physician
0101275784
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/01/2017
Last updated
11/02/2022
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