Healthcare Provider Details

I. General information

NPI: 1275550352
Provider Name (Legal Business Name): NEAL GREGORY MAHUTTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
LEBANON NH
03756-1000
US

IV. Provider business mailing address

15 SUNSET ROCK RD
LEBANON NH
03766-2007
US

V. Phone/Fax

Practice location:
  • Phone: 603-653-9240
  • Fax:
Mailing address:
  • Phone: 603-448-9815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number12001
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number12001
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: