Provider Demographics
NPI:1679678601
Name:GOLDMINZ, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:GOLDMINZ
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 1:280 MERRIMACK ST STE 311
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1779
Mailing Address - Country:US
Mailing Address - Phone:978-691-5690
Mailing Address - Fax:978-691-5693
Practice Address - Street 1:538 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5812
Practice Address - Country:US
Practice Address - Phone:978-683-9201
Practice Address - Fax:978-686-2770
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8661207ND0101X
MA75004207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA070004481OtherRAILROAD MEDICARE
NH0106548Y0NH01OtherANTHEM NEW HAMPSHIRE
MA112292OtherAETNA
NHP00352754OtherRAILROAD MEDICARE
MA4308OtherHARVARD
ME017606OtherANTHEM MAINE
MA075004OtherTUFTS
MAJ12017OtherBCBS MASSACHUSETTS
MA4308OtherHARVARD
MAJ12017Medicare PIN
NHRE1945Medicare PIN