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General NPI Number Information
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NPI Number | 1891953568
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Entity Type | Organization
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Legal Business Name | CROSSROADS FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 194A PLEASANT ST STE 101
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City | CONCORD
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State | NH
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Zip | 03301-2960
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Country | US
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Telephone | 603-856-8828
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Fax | 603-856-8813
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Provider Business Mailing Address
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Address Line | 194A PLEASANT ST STE 101
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City | CONCORD
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State | NH
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Zip | 03301-2960
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Country | US
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Telephone | 603-856-8828
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Fax | 603-856-8813
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Authorized Official
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Title or Position | MANAGER
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Name | DR. PETER COCHRANE LOESER
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Credential | M.D.
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Telephone | 603-856-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 11066
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License Number State | NH
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