Provider Demographics
NPI:1568670115
Name:GOODE, LAUREN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:GOODE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7611 FOREST AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4946
Mailing Address - Country:US
Mailing Address - Phone:804-282-0514
Mailing Address - Fax:804-282-0515
Practice Address - Street 1:7611 FOREST AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4946
Practice Address - Country:US
Practice Address - Phone:804-282-0514
Practice Address - Fax:804-282-0515
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1568670115Medicaid
VA1568670115OtherANTHEM BCBS
VA1568670115OtherANTHEM BCBS
VA1568670115Medicaid