Healthcare Provider Details

I. General information

NPI: 1740221035
Provider Name (Legal Business Name): AMY MARTEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 04/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-7539
US

IV. Provider business mailing address

18 FOUNDRY ST SUITE 201
CONCORD NH
03301-5421
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-0071
  • Fax: 603-228-7014
Mailing address:
  • Phone: 603-228-0071
  • Fax: 603-228-7014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12850
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: