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NPI Code Detail

MEDICARE: APPLEDORE MEDICAL GROUP, INC.

MEDICARE: APPLEDORE MEDICAL GROUP, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174512693
Entity Type Code : Organization
Provider Name (Legal Business Name) : APPLEDORE MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : 29 LAFAYETTE RD
Second Line :
City : NORTH HAMPTON
State : NH
Zip : 03862-2436
Country : US
Telephone Number : 603-964-9370
Fax Number : 603-964-6747
Provider Business Practice Location Address
First Line : 29 LAFAYETTE RD
Second Line :
City : NORTH HAMPTON
State : NH
Zip : 03862-2436
Country : US
Telephone Number : 603-964-9370
Fax Number : 603-964-6747
Authorized Official
Title or Position : VICE PRESIDENT
Name : KEN WASHINGTON
Credential :
Telephone Number : 703-650-2907
Provider Enumeration Date : 10/18/2005
Last Update Date : 04/20/2008

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