Healthcare Provider Details

I. General information

NPI: 1588867667
Provider Name (Legal Business Name): HANOVER CONTINUITY CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 LYME RD SUITE 104
HANOVER NH
03755-1220
US

IV. Provider business mailing address

45 LYME RD SUITE 104
HANOVER NH
03755-1219
US

V. Phone/Fax

Practice location:
  • Phone: 603-643-3320
  • Fax: 603-643-3301
Mailing address:
  • Phone: 603-643-3320
  • Fax: 603-643-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number10169
License Number StateNH

VIII. Authorized Official

Name: DR. ADAM JULES SCHWARZ
Title or Position: PARTNER
Credential: MD
Phone: 603-643-3320