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General NPI Number Information
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NPI Number | 1326243346
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Entity Type | Organization
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Legal Business Name | APPLEDORE MEDICAL GROUP DO NOT USE
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 SHATTUCK WAY
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City | NEWINGTON
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State | NH
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Zip | 03801-7876
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Country | US
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Telephone | 603-929-9724
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Fax |
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Provider Business Mailing Address
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Address Line | 101 SHATTUCK WAY
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City | NEWINGTON
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State | NH
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Zip | 03801-7876
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Country | US
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Telephone | 603-929-9724
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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