Provider Demographics
NPI:1194016154
Name:GODWIN, JAMES LUKE (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LUKE
Last Name:GODWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 CHESTNUT ST STE 320A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4246
Mailing Address - Country:US
Mailing Address - Phone:215-955-8874
Mailing Address - Fax:215-955-2340
Practice Address - Street 1:505 EAST 70TH STREET
Practice Address - Street 2:WEILL CORNELL INTERNAL MEDICINE ASSOCIATES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-746-4749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451617207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology