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General NPI Number Information
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NPI Number | 1538575386
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Entity Type | Organization
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Legal Business Name | NESC STEWARD, LLC
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 154 E CENTRAL ST FL 3
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City | NATICK
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State | MA
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Zip | 01760-3644
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Country | US
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Telephone | 781-430-0060
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Fax | 978-244-2522
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Provider Business Mailing Address
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Address Line | 526 MAIN ST STE 302
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City | ACTON
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State | MA
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Zip | 01720-3301
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Country | US
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Telephone | 978-371-7010
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Fax | 978-371-0522
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Authorized Official
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Title or Position | OWNER/MANAGING PARTNER
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Name | SAMUAL D GOOS
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Credential | MD
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Telephone | 978-371-7010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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