Provider Demographics
NPI:1235216870
Name:GONSALVES, ARTHUR J (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:J
Last Name:GONSALVES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:380 MERRIMACK ST
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5870
Mailing Address - Country:US
Mailing Address - Phone:978-837-3317
Mailing Address - Fax:978-837-3318
Practice Address - Street 1:380 MERRIMACK ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5870
Practice Address - Country:US
Practice Address - Phone:978-837-3317
Practice Address - Fax:978-837-3318
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA791932086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110060172AMedicaid
MAJ30613OtherBLUE CROSS
J3061301Medicare PIN