Provider Demographics
NPI:1518942952
Name:GOODWIN, MONICA LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LOUISE
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LOUISE
Other - Last Name:SINNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:320 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:MN
Mailing Address - Zip Code:56441-1645
Mailing Address - Country:US
Mailing Address - Phone:218-546-7000
Mailing Address - Fax:218-545-4456
Practice Address - Street 1:320 E MAIN ST
Practice Address - Street 2:CUYUNA REGIONAL MEDICAL CENTER
Practice Address - City:CROSBY
Practice Address - State:MN
Practice Address - Zip Code:56441-1645
Practice Address - Country:US
Practice Address - Phone:218-546-7000
Practice Address - Fax:218-545-4456
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN35395207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
236084OtherAMERICA'S PPO
E034OtherTRICARE
089005708OtherMEDICARE
0101129OtherMEDICA
2042748OtherAETNA
6T327GOOtherBCBS
NS1141008752OtherPREFERRED ONE
HP24213OtherHEALTHPARTNERS
080057487OtherRR MEDICARE
109778C750OtherUCARE
MN386308500Medicaid
MN386308500Medicaid
236084OtherAMERICA'S PPO