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Individual

DR. MARY ELLEN JOY GOLDHAMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
15 PARKMAN ST, WAC 108, BOSTON, MA 02114-3117
(617) 726-2707
(617) 724-0189
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-6610
(617) 724-6649

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
224027
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0198676
MA
01
468195
TUFTS HEALTH PLAN
MA
01
J28605
BCBS MA
MA
Enumeration date
10/28/2005
Last updated
07/25/2012
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