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General NPI Number Information
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NPI Number | 1194842898
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Entity Type | Organization
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Legal Business Name | APPLEDORE MEDICAL GROUP INC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 02/10/2009
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Provider Practice Location Address
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Address Line | 333 BORTHWICK AVE
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City | PORTSMOUTH
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State | NH
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Zip | 03801-7128
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Country | US
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Telephone | 603-334-2039
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Fax | 603-433-5180
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Provider Business Mailing Address
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Address Line | 333 BORTHWICK AVE
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City | PORTSMOUTH
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State | NH
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Zip | 03801-7128
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Country | US
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Telephone | 603-334-2039
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Fax | 603-433-5180
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Authorized Official
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Title or Position | VP
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Name | KENNETH WASHINGTON
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Credential |
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Telephone | 703-650-2907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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