Healthcare Provider Details

I. General information

NPI: 1275527913
Provider Name (Legal Business Name): MONELLE G BISSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PROSPECT ST
NASHUA NH
03060-3925
US

IV. Provider business mailing address

PO BOX 3677
NASHUA NH
03061-3677
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-3053
  • Fax: 603-882-0360
Mailing address:
  • Phone: 603-577-7900
  • Fax: 603-577-7972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number9597
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: