Healthcare Provider Details

I. General information

NPI: 1689657355
Provider Name (Legal Business Name): PETER SPENCER HEYL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2005
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 WASHINGTON PL 3RD FLOOR
BEDFORD NH
03110-6736
US

IV. Provider business mailing address

100 HITCHCOCK WAY OB/GYN
MANCHESTER NH
03104-4125
US

V. Phone/Fax

Practice location:
  • Phone: 603-695-2500
  • Fax:
Mailing address:
  • Phone: 603-695-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number0101036041
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number16513
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberLT-3362
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: