| Doctor Name: | STEPHEN J GOODMAN |
| NPI Number: | 1962420968 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 0101023891 |
| Business Practice Address: | 2722 Merrilee Dr Suite 230 Fairfax, VA - 220314400 |
| Business Phone Number: | 7036984483 |
| Business Fax Number: | 7035730880 |
| Mailing Address: | 3816 Woodbine St, CHEVY CHASE |
| State: | MD |
| Postal Code: | 208154957 |
| Phone Number: | 3016572355 |
| Fax Number: | |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 04/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 06/04/2012 |
| NPI Reactivation Date: | 04/15/2013 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 0101023891 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |