Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 56551 | MA |
Y | 111NI0900X | Internist | 56551 | MA |
NPI | 1003066044 |
---|---|
Provider Name | Martin A Goldman |
First Address | Bedford, MA 01730 |
Second Address | Bedford, MA 01730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2008 |
Last Update Date | 26/09/2008 |