Organization
THEODORE GOODMAN MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE GOODMAN MD (PRESIDENT)
(800) 927-0002
Entity
Organization
Contact information
Practice address
800 WASHINGTON ST, CANTON, MA 02021-2562
(781) 828-3019
Mailing address
PO BOX 9132, BROOKLINE, MA 02446-9132
(800) 927-0002
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133728
—
MA
Enumeration date
12/22/2005
Last updated
08/22/2020
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