Individual
MR. LARRY PHILIP GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 ENDICOTT ST, SUITE 200, DANVERS, MA 01923-3623
(978) 882-6868
(978) 882-6855
Mailing address
104 ENDICOTT ST, SUITE 200, DANVERS, MA 01923-3623
(978) 882-6868
(978) 882-6855
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
49380
MA
2086S0129X
Vascular Surgery Physician
49380
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3023125
—
MA
Enumeration date
09/08/2005
Last updated
05/18/2012
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