Provider Demographics
NPI:1285662759
Name:GOUMAS, DOUGLAS M (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:M
Last Name:GOUMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 RIVERSIDE ST
Mailing Address - Street 2:STE 101
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1373
Mailing Address - Country:US
Mailing Address - Phone:603-883-0091
Mailing Address - Fax:603-881-3739
Practice Address - Street 1:35 KOSCIUSZKO ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1608
Practice Address - Country:US
Practice Address - Phone:603-634-0080
Practice Address - Fax:603-881-3739
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11057207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH8709923OtherCIGNA PROVIDER #
NH1922164797OtherNPI, PROVIDER LOCATION
NH1841320207OtherNPI, PROVIDER LOCATION
NH01Y002717NH01OtherANTHEM BC/BS PROVIDER #
NH1881772242OtherNPI, PROVIDER LOCATION
NH1861558645OtherNPI, PROVIDER LOCATION
NH1932256914OtherNPI, PROVIDER LOCATION
NH30201613Medicaid
NH1801952692OtherNPI, PROVIDER LOCATION
NHG94468OtherHARVARD HEALTH PROVIDER #
NH1801952692OtherNPI, PROVIDER LOCATION
NH0132510001Medicare NSC
NH0132510005Medicare NSC
NH1922164797OtherNPI, PROVIDER LOCATION
NH1841320207OtherNPI, PROVIDER LOCATION
NH1881772242OtherNPI, PROVIDER LOCATION
NH0132510004Medicare NSC