Provider Demographics
NPI:1750726253
Name:GOODMAN, SETH M (DO)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:M
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:13830 W CAMINO DEL SOL STE 240
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4746
Mailing Address - Country:US
Mailing Address - Phone:623-254-7375
Mailing Address - Fax:623-259-6754
Practice Address - Street 1:13830 W CAMINO DEL SOL STE 240
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4746
Practice Address - Country:US
Practice Address - Phone:623-254-7375
Practice Address - Fax:623-259-6754
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ006523207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology