Healthcare Provider Details

I. General information

NPI: 1558866053
Provider Name (Legal Business Name): ELIZABETH SPELLMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 GRIFFIN RD
PORTSMOUTH NH
03801-2093
US

IV. Provider business mailing address

155 GRIFFIN RD
PORTSMOUTH NH
03801-2093
US

V. Phone/Fax

Practice location:
  • Phone: 603-431-6011
  • Fax:
Mailing address:
  • Phone: 603-431-6011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number22659
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: