Organization
SOUTH SHORE SKIN SURGEONS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL D GOOS MD (OWNER/MANAGING PARTNER)
(978) 371-7010
Entity
Organization
Contact information
Practice address
400 WASHINGTON STREET, SUITE 200, BRAINTREE, MA 02184
(781) 380-8150
(781) 380-8160
Mailing address
526 MAIN ST STE 302, ACTON, MA 01720-3301
(978) 371-7010
(978) 371-0522
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
155146
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9715771
—
MA
01
—
M17207
GROUP BLUE SHIELD
MA
01
—
M21193
MEDICARE PTAN
MA
Enumeration date
11/28/2006
Last updated
03/06/2025
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