Organization
ADULT & PEDIATRIC DERMATOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL D GOOS MD (MANAGING PARTNER)
(978) 371-7010
Entity
Organization
Contact information
Practice address
54 BAKER AVENUE EXT STE 305&306, CONCORD, MA 01742-2137
(978) 371-7010
(978) 371-0522
Mailing address
526 MAIN ST STE 302, ACTON, MA 01720-3301
(978) 371-7010
(978) 371-0522
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
607334
TUFTS HEALTH PLAN GROUP #
MA
01
—
M17456
BC/BS OF MA GROUP NUMBER
MA
Enumeration date
01/19/2006
Last updated
10/28/2024
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