1457539983 NPI number — COURTNEY GOODWIN MASEAR M.D.

Table of content: COURTNEY GOODWIN MASEAR M.D. (NPI 1457539983)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457539983 NPI number — COURTNEY GOODWIN MASEAR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MASEAR
Provider First Name:
COURTNEY
Provider Middle Name:
GOODWIN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOODWIN
Provider Other First Name:
COURTNEY
Provider Other Middle Name:
JARRARD
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457539983
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 ORLEANS STREET, ZAYED 8120
Provider Second Line Business Mailing Address:
JOHNS HOPKINS HOSPITAL
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21287
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 ORLEANS STREET, ZAYED 8120
Provider Second Line Business Practice Location Address:
JOHNS HOPKINS HOSPITAL
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-955-5608
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  D0079235 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)