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Individual

DR. ALLAN MOISES GOLDSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 FRUIT STREET, WRN 11, BOSTON, MA 02114-2696
(617) 726-0270
(617) 726-2167
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
150801
MA
2086S0120X
Pediatric Surgery Physician
150801
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0172731
MA
01
730779
TUFTS HEALTH PLAN
MA
01
J24954
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
12/20/2012
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