Healthcare Provider Details

I. General information

NPI: 1508847120
Provider Name (Legal Business Name): DENNIS S BADMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 12/12/2019
Certification Date: 12/12/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 MEADOW ST
SANBORNVILLE NH
03872-4329
US

IV. Provider business mailing address

131 MEADOW ST
SANBORNVILLE NH
03872-4329
US

V. Phone/Fax

Practice location:
  • Phone: 603-871-8227
  • Fax: 603-871-8285
Mailing address:
  • Phone: 603-871-8227
  • Fax: 603-871-8285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8928
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: