Provider Demographics
NPI:1548240039
Name:GOOS, SAMUEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:D
Last Name:GOOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:526 MAIN ST
Mailing Address - Street 2:STE 302
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3301
Mailing Address - Country:US
Mailing Address - Phone:978-371-7010
Mailing Address - Fax:978-371-0522
Practice Address - Street 1:54 BAKER AVENUE EXT STE 302
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2137
Practice Address - Country:US
Practice Address - Phone:978-371-7010
Practice Address - Fax:978-371-0522
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2022-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA56678207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5763OtherHEALTHSOURCE
MA8150OtherFALLON COMMUNITY HEALTH C
MA070015454OtherRAILROAD MEDICARE
MAJ07521OtherBC/BS OF MA
MA056678OtherTUFTS HEALTH PLAN
MA4126119OtherAETNA US HEALTH CARE
MA0009289OtherCIGNA
MA4293OtherHARVARD COMMUNITY HEALTH
MA0009289OtherCIGNA
MAJ07521Medicare ID - Type Unspecified