Provider Demographics
NPI:1447448055
Name:GOLD, SAMUEL C (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:C
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:835 HANOVER ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-5401
Mailing Address - Country:US
Mailing Address - Phone:603-641-5081
Mailing Address - Fax:603-641-5348
Practice Address - Street 1:835 HANOVER ST
Practice Address - Street 2:SUITE 304
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-5401
Practice Address - Country:US
Practice Address - Phone:603-641-5081
Practice Address - Fax:603-641-5348
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH7982207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30002630Medicaid
NH30002630Medicaid
NHNH9728Medicare PIN