Healthcare Provider Details

I. General information

NPI: 1801868849
Provider Name (Legal Business Name): DAVID ALBAN STEVENSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

734 N MAIN ST
LACONIA NH
03246-2777
US

IV. Provider business mailing address

250 PLEASANT ST. MEDICAL STAFF SERVICES
CONCORD NH
03301-7539
US

V. Phone/Fax

Practice location:
  • Phone: 603-737-0700
  • Fax: 603-227-7589
Mailing address:
  • Phone: 603-227-7000
  • Fax: 603-228-3307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number9439
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: