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NPI Code Detail

MEDICARE: ELLIOT PHYSICIANS NETWORK

MEDICARE: ELLIOT PHYSICIANS NETWORK
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

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CG2227OTHERRR MEDICARE GROUP #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558351619
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELLIOT PHYSICIANS NETWORK
Provider Business Mailing Address
First Line : 25 S RIVER RD
Second Line : ELLIOT FAMILY MEDICINE AT BEDFORD COMMONS
City : BEDFORD
State : NH
Zip : 03110-6708
Country : US
Telephone Number : 603-626-4392
Fax Number : 603-626-4462
Provider Business Practice Location Address
First Line : 25 S RIVER RD
Second Line : ELLIOT FAMILY MEDICINE AT BEDFORD COMMONS
City : BEDFORD
State : NH
Zip : 03110-6708
Country : US
Telephone Number : 603-626-4392
Fax Number : 603-626-4462
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS & FINANCE
Name : RICHARD P. HERMAN
Credential :
Telephone Number : 603-663-5766
Provider Enumeration Date : 10/28/2005
Last Update Date : 06/20/2008

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Directions to “ELLIOT PHYSICIANS NETWORK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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