MR. ROCELIOUS GOODSON III (NPI# 1992863872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992863872 |
| Entity Type | Individual |
| Full Name | MR. ROCELIOUS GOODSON III |
| Credential | PA-C |
| Practice Address |
4241 Maple St Suite 200 D Dearborn MI 48126-3826 |
| Mailing Address |
5790 Newberry Estates Dr Westland MI 48185-8300 |
| Practice Telephone | 3135841940 |
| Practice Fax Number | 3135841945 |
| Mailing Telephone | 3138506552 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2008-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601004396 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4241 MAPLE ST SUITE 200 D |
| City | DEARBORN |
| State | MI |
| Zip Code | 48126-3826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164812582 | Senior Care Physicians | General Practice | 4241 Maple St, Suite 200c, Dearborn, MI 48126-3826 | 2015-01-24 |
| 1194029793 | Alaa Hussein Ali Md PC | Family Medicine | 4241 Maple St, Suite 250, Dearborn, MI 48126-3826 | 2010-12-23 |
| 1275857989 | John Kay Nwadinobi | Physician Assistant | 4241 Maple St, Dearborn, MI 48126-3826 | 2010-03-24 |
| 1629267133 | Tete Oniango | Surgery | 4241 Maple St, Dearborn, MI 48126-3826 | 2007-10-21 |
| 1982750881 | Everett Bryant | Family Medicine | 4241 Maple St, Suite 200d, Dearborn, MI 48126-3826 | 2007-01-25 |
| 1164579686 | David Sharath | Physical Therapist | 4241 Maple St, Suite 150, Dearborn, MI 48126-3826 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194323303 | Aq Dental Group Pllc | Clinic/Center | 10413 Ford Road, Units M & N, Dearborn, MI 48126 | 2020-10-12 |
| 1275148165 | Anasthesia Pain Service PC | Clinic/Center | 15350 Michigan Ave, Dearborn, MI 48126 | 2020-09-09 |
| 1417501958 | Ximena Noemi Ortega | Behavior Technician | 6241 Miller Rd, Dearborn, MI 48126 | 2019-08-01 |
| 1912478827 | Abar Alghazali | Behavior Technician | 4641 Lois, Dearborn, MI 48126 | 2018-12-17 |
| 1861972457 | Laboratory Specialists of Michigan, LLC | Clinical Medical Laboratory | 13530 Michigan Ave Ste 240, Dearborn, MI 48126 | 2018-08-14 |
| 1528544806 | Farah Osman | Pharmacist | 14715 Ford Rd, Dearborn, MI 48126 | 2018-07-19 |
| 1255821328 | Loyal Pharmacy LLC | Pharmacy | 7118 Greenfield Rd St(b), Dearborn, MI 48126 | 2018-05-15 |
| 1952803900 | Neetika Kesar | Physical Therapist | 15051, Ford Road, Dearborn, MI 48126 | 2018-03-06 |
| 1396247607 | David Jerome Kurcz | Physical Therapy Assistant | 15051 Ford Road, Henry Ford Village, Dearborn, MI 48126 | 2018-03-02 |
| 1043732506 | Shadiya Ahmed | Dentist | 4700 Schaefer Rd Ste 190, Dearborn, MI 48126 | 2017-07-16 |
| Find all providers in zip 48126 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033345863 | Stephanie M Anselmi | Physician Assistant | 21516 Gregory St, Dearborn, MI 48124-3006 | 2009-06-08 |
| 1669636130 | Lisa A Boros-laurain | Physician Assistant | 3133 S.telegraph, Dearborn, MI 48124 | 2008-07-15 |
| 1912169343 | Amin Huballah | Physician Assistant | 7526 Wyoming St, Suite #2, Dearborn, MI 48126-1690 | 2008-06-26 |
| 1982743209 | Jessica Ashley Preston | Physician Assistant | 2100 Monroe St, Dearborn, MI 48124-2923 | 2007-02-05 |
| 1417995507 | Inshad Hassan Beydoun | Physician Assistant | 4789 Westland St, Dearborn, MI 48126-2809 | 2006-06-02 |
| 1215922109 | Houssam M Fadlallah | Physician Assistant | 6500 Schaefer Rd, Suite A, Dearborn, MI 48126 | 2005-09-16 |
| 1548816440 | Aisha Akilah Stokes | Physician Assistant | 6050 Greenfield Rd, Dearborn, MI 48126-6004 | 2019-08-15 |
| 1740753698 | Brittany N Glines | Physician Assistant | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2019-01-03 |
| 1689197659 | Rania Krayem | Physician Assistant | 6450 Maple St, Dearborn, MI 48126-2259 | 2017-07-21 |
| 1144769084 | Nadine Tarraf | Physician Assistant | 1022 N Telegraph Rd, Dearborn, MI 48128-1622 | 2017-02-13 |
| Find all providers in DEARBORN | ||||
Please comment or provide details below to improve the information on MR. ROCELIOUS GOODSON III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.