MEDICARE: DR. WILLIAM S GOODMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	35554	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	M08812	OTHER	MA	BCBS
3	700855	OTHER	MA	TUFTS
4	801718	OTHER	MA	HPHC

General Provider Information

NPI Number	:	1477542637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM S GOODMAN MD

Provider Business Mailing Address
First Line	:	460 TOTTEN POND RD
Second Line	:	C/O MZI
City	:	WALTHAM
State	:	MA
Zip	:	02451-1991
Country	:	US
Telephone Number	:	781-890-9933
Fax Number	:	781-890-9950

Provider Business Practice Location Address
First Line	:	67 UNION ST
Second Line	:
City	:	NATICK
State	:	MA
Zip	:	01760-7700
Country	:	US
Telephone Number	:	508-651-1144
Fax Number	:	508-653-9759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	04/29/2011

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Directions to “ DR. WILLIAM S GOODMAN MD” Practice Location

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