Provider Demographics
NPI:1891834388
Name:GOETZEL, ERICH (MD)
Entity Type:Individual
Prefix:
First Name:ERICH
Middle Name:
Last Name:GOETZEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:86 BAKER AVENUE EXT
Mailing Address - Street 2:STE 100
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2132
Mailing Address - Country:US
Mailing Address - Phone:978-369-1113
Mailing Address - Fax:617-507-6525
Practice Address - Street 1:35 JOHN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1101
Practice Address - Country:US
Practice Address - Phone:978-275-3879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2155422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry