Provider Demographics
NPI:1497754055
Name:GOODMAN, LOIS S (MD)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:S
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:45 COLPITTS RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1546
Mailing Address - Country:US
Mailing Address - Phone:781-899-7778
Mailing Address - Fax:781-899-0475
Practice Address - Street 1:45 COLPITTS RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1546
Practice Address - Country:US
Practice Address - Phone:781-899-7778
Practice Address - Fax:781-899-0475
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-17
Last Update Date:2010-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA36529207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0016763OtherNHP-MA (10)
MA036529OtherTUFTS
MAGOMO9146OtherBCBS (6)
MA36529OtherMEDICAL LICENSE (1)
MAGOMO9146OtherBCBS-MA (218)
MA043550681OtherHEALTH NET OF NE (62)
MA27416OtherCMSP/HSP (401)
MA3580607003OtherCIGNA (33)
MA13636OtherHPHC
MA578760OtherHEALTHSOURCE
MA0016763OtherNHP-MA (10)
MAGOMO9146OtherBCBS-MA (218)