Provider Demographics
NPI:1144335928
Name:GOODWIN, ROBERT STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEVEN
Last Name:GOODWIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6740 ALEXANDER BELL DR # 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2248
Mailing Address - Country:US
Mailing Address - Phone:410-564-0000
Mailing Address - Fax:410-564-0032
Practice Address - Street 1:6740 ALEXANDER BELL DR # 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2248
Practice Address - Country:US
Practice Address - Phone:410-564-0000
Practice Address - Fax:410-564-0032
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD23081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8781248EMedicare ID - Type Unspecified
D71528Medicare UPIN