Healthcare Provider Details

I. General information

NPI: 1376801860
Provider Name (Legal Business Name): HILLARY SPENCER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 12/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR DHMC, DEPARTMENT OF PEDIATRICS
LEBANON NH
03756-1000
US

IV. Provider business mailing address

1 MEDICAL CENTER DR DHMC, DEPARTMENT OF PEDIATRICS
LEBANON NH
03756-1000
US

V. Phone/Fax

Practice location:
  • Phone: 603-653-9850
  • Fax:
Mailing address:
  • Phone: 603-653-9850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17134
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: