Doctor Name: | DR. ROBERT W. GOODWIN |
NPI Number: | 1174618094 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD16090 |
Business Practice Address: | 45 Mohouli St Hilo, HI - 967207210 |
Business Phone Number: | 8084309555 |
Business Fax Number: | |
Mailing Address: | 45 Mohouli St, HILO |
State: | HI |
Postal Code: | 967207210 |
Phone Number: | 8084309555 |
Fax Number: | |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 03/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD16090 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |