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NPI Code Detail

MEDICARE: DR. PETER BOYLSTON DELFAUSSE M.D.

MEDICARE: DR. PETER BOYLSTON DELFAUSSE M.D.
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
12084P0800XPsychiatry Physician5175NH

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 : 1891744272
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER BOYLSTON DELFAUSSE M.D.
Provider Business Mailing Address
First Line : 224 LITTLE POND RD
Second Line :
City : CONCORD
State : NH
Zip : 03301-6204
Country : US
Telephone Number : 603-224-6793
Fax Number :
Provider Business Practice Location Address
First Line : 99 PLEASANT ST
Second Line :
City : CONCORD
State : NH
Zip : 03301-3852
Country : US
Telephone Number : 603-271-5263
Fax Number : 603-271-5209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 09/02/2011

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