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General NPI Number Information
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NPI Number | 1457318578
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Entity Type | Organization
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Legal Business Name | SAMUEL C GOLD MD PA
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 835 HANOVER ST SUITE 304
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City | MANCHESTER
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State | NH
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Zip | 03104
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Country | US
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Telephone | 603-641-5081
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Fax | 603-641-5348
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Provider Business Mailing Address
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Address Line | 835 HANOVER ST SUITE 304
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City | MANCHESTER
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State | NH
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Zip | 03104
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Country | US
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Telephone | 603-641-5081
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Fax | 603-641-5348
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Authorized Official
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Title or Position | PRESIDENT PHYSICIAN
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Name | DR. SAMUEL CARL GOLD
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Credential | MD
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Telephone | 603-641-5081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 7982
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License Number State | NH
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