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General NPI Number Information
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NPI Number | 1194702555
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Entity Type | Individual
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Provider Name | THOMAS A GOODMAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 100 BOSTON RD
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City | GROTON
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State | MA
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Zip | 01450-1860
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Country | US
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Telephone | 978-448-4300
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Fax | 978-448-4040
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Provider Business Mailing Address
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Address Line | PO BOX 369
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City | GROTON
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State | MA
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Zip | 01450-0369
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Country | US
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Telephone | 978-448-4300
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Fax | 978-448-4040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 73832
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License Number State | MA
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