Provider Demographics
NPI:1851272488
Name:GOODTIME FAMILY CARE, P.C.
Entity type:Organization
Organization Name:GOODTIME FAMILY CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH-VENATIUS
Authorized Official - Middle Name:I
Authorized Official - Last Name:OSUAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-325-5700
Mailing Address - Street 1:7131 LIBERTY RD STE 103
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4580
Mailing Address - Country:US
Mailing Address - Phone:410-325-5700
Mailing Address - Fax:410-325-5765
Practice Address - Street 1:5805 MORAVIA RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-6133
Practice Address - Country:US
Practice Address - Phone:410-325-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOODTIME FAMILY CARE, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty