Healthcare Provider Details

I. General information

NPI: 1952324071
Provider Name (Legal Business Name): SUSAN BAYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 W MAIN ST SUITE 200
TILTON NH
03276-5044
US

IV. Provider business mailing address

630 W MAIN ST SUITE 200
TILTON NH
03276-5044
US

V. Phone/Fax

Practice location:
  • Phone: 603-286-3371
  • Fax:
Mailing address:
  • Phone: 603-286-3371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7250
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: