Healthcare Provider Details

I. General information

NPI: 1295843175
Provider Name (Legal Business Name): SARAH E WALSH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH E MASTERS

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 LOUDON RD BLDG 3
CONCORD NH
03301-5600
US

IV. Provider business mailing address

105 LOUDON RD BLDG 3 PO BOX 2032
CONCORD NH
03301-5600
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-0547
  • Fax: 603-226-7508
Mailing address:
  • Phone: 603-228-0547
  • Fax: 603-226-7508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number14275
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: