Healthcare Provider Details

I. General information

NPI: 1144265307
Provider Name (Legal Business Name): NEW HAMPSHIRE RADIOLOGY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 RIVERWAY PL
BEDFORD NH
03110-6768
US

IV. Provider business mailing address

703 RIVERWAY PL
BEDFORD NH
03110-6768
US

V. Phone/Fax

Practice location:
  • Phone: 603-627-1661
  • Fax: 603-669-6944
Mailing address:
  • Phone: 603-627-1661
  • Fax: 603-669-6944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK D LUEDKE
Title or Position: PRESIDENT
Credential: MD
Phone: 603-627-1661