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General NPI Number Information
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NPI Number | 1477542637
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Entity Type | Individual
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Provider Name | WILLIAM S GOODMAN MD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 67 UNION ST
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City | NATICK
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State | MA
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Zip | 01760-7700
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Country | US
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Telephone | 508-651-1144
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Fax | 508-653-9759
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Provider Business Mailing Address
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Address Line | 460 TOTTEN POND RD C/O MZI
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City | WALTHAM
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State | MA
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Zip | 02451-1991
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Country | US
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Telephone | 781-890-9933
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Fax | 781-890-9950
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35554
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License Number State | MA
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