| Michael R Goodman Md Pc | |
|
9239 West Center Road Suite 221 Omaha NE 68124-1968 | |
| (402) 354-8025 | |
| (402) 354-8044 |
| Full Name | Michael R Goodman Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9239 West Center Road, Omaha, Nebraska |
| Authorized Official Name and Position | Michael R Goodman (PRESIDENT) |
| Authorized Official Contact | 4023548025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael R Goodman Md Pc 9239 West Center Road Suite 221 Omaha NE 68124-1968 Ph: (402) 354-8025 | Michael R Goodman Md Pc 9239 West Center Road Suite 221 Omaha NE 68124-1968 Ph: (402) 354-8025 |
| NPI Number | 1881903151 |
|---|---|
| Provider Enumeration Date | 10/04/2010 |
| Last Update Date | 10/04/2010 |
| Medicare PECOS PAC ID | 3971799461 |
|---|---|
| Medicare Enrollment ID | O20101123000605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881903151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 18052 (Nebraska) | Primary |
| Provider Name | Michael R Goodman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992770044 PECOS PAC ID: 7113968884 Enrollment ID: I20050512001016 |
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