Provider Demographics
NPI:1306941448
Name:GOODMAN, LANCE RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:RICHARD
Last Name:GOODMAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:480 MAPLE ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-4065
Mailing Address - Country:US
Mailing Address - Phone:978-406-4234
Mailing Address - Fax:978-921-2968
Practice Address - Street 1:480 MAPLE ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-4065
Practice Address - Country:US
Practice Address - Phone:978-406-4234
Practice Address - Fax:978-921-2968
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2021-08-06
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Provider Licenses
StateLicense IDTaxonomies
MA254544208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics