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General NPI Number Information
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NPI Number | 1841311313
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Entity Type | Individual
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Provider Name | ANDREW CHILDS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 603-650-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 281 LINCOLN ST MED STAFF SRVCS
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City | WORCESTER
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State | MA
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Zip | 01605-2138
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Country | US
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Telephone | 508-334-8015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 223346
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 23083
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License Number State | NH
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