Healthcare Provider Details

I. General information

NPI: 1740233816
Provider Name (Legal Business Name): PETER H CROW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TECHNOLOGY DR
HOOKSETT NH
03106-2504
US

IV. Provider business mailing address

200 TECHNOLOGY DR
HOOKSETT NH
03106-2504
US

V. Phone/Fax

Practice location:
  • Phone: 603-622-6484
  • Fax: 603-622-7438
Mailing address:
  • Phone: 603-622-6484
  • Fax: 603-622-7438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number10859
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier30200936
Identifier TypeMEDICAID
Identifier StateNH
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: