Provider Demographics
NPI:1407824626
Name:GOODMAN, SUSAN CATES (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:CATES
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3495 HACKS CROSS RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-8803
Mailing Address - Country:US
Mailing Address - Phone:901-526-7444
Mailing Address - Fax:901-271-2606
Practice Address - Street 1:3495 HACKS CROSS RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125
Practice Address - Country:US
Practice Address - Phone:901-526-7444
Practice Address - Fax:901-271-2606
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA053916207ZP0102X
TN14091207ZP0102X, 207ZP0102X
MS10208207ZP0102X
SC27689207ZP0102X
ARE3528207ZP0102X
NC207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR149681001Medicaid
AR56822OtherMEDICARE PROFESSIONAL
AR106515709OtherGROUP MEDICAID
AR18019OtherGROUP MEDICARE
AR406690238OtherRAILROAD MEDICARE