Provider Demographics
NPI:1144281221
Name:GOH, MICHELE S (MD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:S
Last Name:GOH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-2765
Mailing Address - Country:US
Mailing Address - Phone:978-562-0564
Mailing Address - Fax:978-562-5646
Practice Address - Street 1:157 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-2765
Practice Address - Country:US
Practice Address - Phone:978-562-0564
Practice Address - Fax:978-562-5646
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220384207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2100771Medicaid
A37453Medicare ID - Type Unspecified
MA2100771Medicaid