Provider Demographics
NPI:1346565884
Name:GOODWIN, DAVID S (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:GOODWIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:21475 RIDGETOP CIR
Mailing Address - Street 2:STE 150
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6580
Mailing Address - Country:US
Mailing Address - Phone:703-444-5000
Mailing Address - Fax:703-444-4999
Practice Address - Street 1:25055 RIDING PLZ
Practice Address - Street 2:STE 260
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-5917
Practice Address - Country:US
Practice Address - Phone:703-272-5000
Practice Address - Fax:703-957-3804
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-27
Last Update Date:2021-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101260025207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery