Healthcare Provider Details

I. General information

NPI: 1407484710
Provider Name (Legal Business Name): CAROLINE ELIZABETH WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 OLD FREMONT ROAD EXT
RAYMOND NH
03077-2380
US

IV. Provider business mailing address

6 BUTTRICK RD STE 102
LONDONDERRY NH
03053-3417
US

V. Phone/Fax

Practice location:
  • Phone: 603-537-1300
  • Fax: 603-244-7018
Mailing address:
  • Phone: 603-537-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24666
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: