Provider Demographics
NPI:1578872941
Name:GOODMAN, STEVEN JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JEFFREY
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1314 HIDDEN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-9470
Mailing Address - Country:US
Mailing Address - Phone:518-222-6373
Mailing Address - Fax:
Practice Address - Street 1:1314 HIDDEN LAKES DR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-9470
Practice Address - Country:US
Practice Address - Phone:518-222-6373
Practice Address - Fax:843-856-4001
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY127508208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery