Healthcare Provider Details

I. General information

NPI: 1801834882
Provider Name (Legal Business Name): CHARLES D LONDON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: C. DAVID LONDON M.D.

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 ALUMNI DR ANESTHESIA DEPT.
EXETER NH
03833-2128
US

IV. Provider business mailing address

5 ALUMNI DR EXETER HOSPITAL
EXETER NH
03833-2128
US

V. Phone/Fax

Practice location:
  • Phone: 603-580-6624
  • Fax: 603-580-6620
Mailing address:
  • Phone: 800-720-1664
  • Fax: 207-753-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number5997
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: