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NPI Code Detail

MEDICARE: ROLAND A. LAVALLEE MD

MEDICARE: ROLAND A. LAVALLEE MD
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
1207QA0401XAddiction Medicine (Family Medicine) Physician8396NH
2207Q00000XFamily Medicine PhysicianNH 8396NH

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 : 1326245747
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROLAND A. LAVALLEE MD
Provider Business Mailing Address
First Line : 20 HUNTERS RD
Second Line :
City : BEDFORD
State : NH
Zip : 03110-5014
Country : US
Telephone Number : 603-472-4424
Fax Number :
Provider Business Practice Location Address
First Line : 140 QUEEN CITY AVE
Second Line :
City : MANCHESTER
State : NH
Zip : 03103-7122
Country : US
Telephone Number : 603-626-9500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 05/21/2019

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Directions to “ ROLAND A. LAVALLEE MD” Practice Location

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