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General NPI Number Information
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NPI Number | 1851450928
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Entity Type | Organization
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Legal Business Name | PLEASANT STREET FAMILY MEDICINE
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 280 PLEASANT ST
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City | CONCORD
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State | NH
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Zip | 03301-2553
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Country | US
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Telephone | 603-226-3400
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Fax | 603-228-4765
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Provider Business Mailing Address
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Address Line | 280 PLEASANT ST
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City | CONCORD
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State | NH
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Zip | 03301-2553
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Country | US
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Telephone | 603-226-3400
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Fax | 603-228-4765
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DONNA M TRUMBLE
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Credential |
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Telephone | 603-226-3400
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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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