Provider Demographics
NPI:1578567434
Name:GOLDMAN, RICHARD A (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:500 MERRIMACK ST
Mailing Address - Street 2:RIVERWALK
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1756
Mailing Address - Country:US
Mailing Address - Phone:978-557-8900
Mailing Address - Fax:978-557-8859
Practice Address - Street 1:500 MERRIMACK ST
Practice Address - Street 2:RIVERWALK
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1756
Practice Address - Country:US
Practice Address - Phone:978-557-8900
Practice Address - Fax:978-557-8859
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2012-11-19
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Provider Licenses
StateLicense IDTaxonomies
MA79513207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA079513OtherTUFTS HEALTH PLAN
MA110055047AMedicaid
MA1578567434OtherAETNA HMO
MA4255238OtherAETNA NON HMO
678825OtherHEALTHSOURCE
975006OtherNETWORK HEALTH
25-00653OtherEVERCARE
0011292OtherNEIGHBORHOOD HEALTH PLAN
MD300020OtherHARVARD PILGRIM HEALTH CA
D76230OtherANTHEM BLUE CROSS
MA1578567434OtherFALLON COMMUNITY HEALTH PLAN
MA3130967Medicaid
NH30200158OtherNH MEDICAID
MAJ30920OtherBLUE CROSS BLUE SHIELD
060061826OtherRAILROAD MEDICARE
9925892OtherCIGNA HEALTHCARE
0011292OtherNEIGHBORHOOD HEALTH PLAN
D76230OtherANTHEM BLUE CROSS