DR. GARY R GOODMAN (NPI# 1982669024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982669024 |
| Entity Type | Individual |
| Full Name | DR. GARY R GOODMAN |
| Credential | MD |
| Practice Address |
22250 Providence Dr Ste 606 Southfield MI 48075-6214 |
| Mailing Address |
1030 Harrington St Ste 203 Mount Clemens MI 48043-2967 |
| Practice Telephone | 2484431281 |
| Practice Fax Number | 2484431411 |
| Mailing Telephone | 5864939229 |
| Mailing Fax Number | 5864934396 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2019-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4301044225 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 10 3282495 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477574978 | Gary Sean Goodman | Pharmacist | 6000 Quiet Glow Ave, Las Vegas, NV 89139-6422 | 2006-07-21 |
| 1629353735 | Gary Goodman | Case Manager/Care Coordinator | 64 Industrial Park Rd, Plymouth, MA 02360-4881 | 2011-10-20 |
| 1992988869 | Gary H Goodman | Dentist | 3455 Main St, Springfield, MA 01107-1147 | 2007-12-13 |
| 1255402251 | Gary E. Goodman | Internal Medicine | 1221 Madison St, Seattle, WA 98104-3588 | 2006-11-13 |
| 1588758551 | Gary Goodman | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2006-10-03 |
| 1740232172 | Gary A Goodman | Emergency Medicine | 1401 W Seminole Blvd, Central Florida Regional Hospital, Dept of Emerg. Med., Sanford, FL 32771-6743 | 2006-05-16 |
| 1972581841 | Gary R Goodman | Urology | 3520 E 15th St, Suite 200, Loveland, CO 80538-8938 | 2006-01-02 |
| 1316930381 | Gary Neal Goodman | Psychologist | 11110 N Tatum Blvd, Suite 103, Phoenix, AZ 85028-1607 | 2005-08-25 |
| 1598758617 | Gary Richard Goodman | Podiatrist | 2350 Sunset Point Rd, Suite A, Clearwater, FL 33765-1443 | 2005-08-24 |
| 1811999485 | Gary M Goodman | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2005-08-12 |
| Street Address |
22250 PROVIDENCE DR STE 606 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-6214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275590523 | Michael Won Kyu Lee | Surgery | 22250 Providence Dr Ste 606, Southfield, MI 48075-6214 | 2006-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346570595 | Zewditu Elsabet Asfaw | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 16001 W 9 Mile Rd Fl 3, Southfield, MI 48075-4818 | 2010-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710479191 | United Surgical Associates Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2150 Association Dr, Okemos, MI 48864-4909 | 2018-06-01 |
| 1841719531 | Liberty Cardiolvascular Group Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5250 Auto Club Dr Ste 300l, Dearborn, MI 48126-2619 | 2017-09-13 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1871982249 | Michigan Heart Lung and Vein Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2757 Leonard Ne, Ste 200, Grand Rapids, MI 49525-5807 | 2015-01-22 |
| 1154767382 | Michigan Thoracic Institute, PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6640 Kings Ct, West Bloomfield, MI 48322-2779 | 2013-05-15 |
| 1679815898 | Hanna Park | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne Rm 8830, Grand Rapids, MI 49503 | 2013-03-26 |
| 1760730469 | Hurley Medical Center | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1125 S. Linden Road, Suite 700, Flint, MI 48532-4069 | 2012-08-28 |
| 1245588326 | Bakri Kaakeh | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4701 Towne Centre Rd Ste 301, Saginaw, MI 48604-2800 | 2012-08-21 |
| 1447521554 | Eduardo Arciniegas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3236 Interlaken St, West Bloomfield, MI 48323-1824 | 2012-01-20 |
| 1629358650 | Steven S. Demos | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3739 Highgate Rd, Norton Shores, MI 49441-5017 | 2011-08-22 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.