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MASON R GOODMAN MD

Allergy

Indianapolis, Indiana

Provider NPI: 1508848433

Provider Information:
 MASON R GOODMAN MD


Practice Location:
8424 NAAB RD STE 1H  INDIANAPOLIS, IN 46260 US
Tel: 317-338-7780  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207RG0300XPhysicians
Internal Medicine
Geriatric Medicine
IN01024689A
N207KA0200XPhysicians
Allergy & Immunology
IN01024689A
Y207RP1001XPhysicians
Internal Medicine
IN01024689A

Other Provider Identifiers:

IssuerNumberStateType
100062950IN05
RAILROAD GROUPCI047301
RAILROAD MEDICARE PIN29000648301
BC/BS000000081345IN01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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