Provider Demographics
NPI:1932294717
Name:GOODWIN, MAJE D (MD)
Entity Type:Individual
Prefix:
First Name:MAJE
Middle Name:D
Last Name:GOODWIN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:170 MEDICAL PARK RD
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117
Mailing Address - Country:US
Mailing Address - Phone:704-663-5240
Mailing Address - Fax:704-663-5399
Practice Address - Street 1:170 MEDICAL PARK RD
Practice Address - Street 2:SUITE 102A
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117
Practice Address - Country:US
Practice Address - Phone:704-663-5240
Practice Address - Fax:704-663-5399
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2019-12-12
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Provider Licenses
StateLicense IDTaxonomies
TN41338208000000X
NC2009-00933208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics