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275 Mammoth Rd Ste 4 Derryfield Medical Group Manchester NH 03109-4133 | |
(603) 624-4380 | |
(603) 624-4805 |
Full Name | |
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Speciality | Internal Medicine |
Location | 275 Mammoth Rd Ste 4, Manchester, New Hampshire |
Authorized Official Name and Position | Richard P. Herman (DIRECTOR OF OPERATIONS & FINANCE) |
Authorized Official Contact | 6036635766 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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275 Mammoth Rd Ste 4 Derryfield Medical Group Manchester NH 03109-4133 Ph: (603) 624-4380 | 275 Mammoth Rd Ste 4 Derryfield Medical Group Manchester NH 03109-4133 Ph: (603) 624-4380 |
NPI Number | 1205821295 |
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Provider Enumeration Date | 09/15/2005 |
Last Update Date | 06/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205821295 | NPI | - | NPPES |
30210576 | Medicaid | NH | |
CG2227 | Other | NH | RR MEDICARE GROUP # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Healthways Family Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 59 Sheffield Rd, Manchester, NH 03103 Phone: 603-606-7020 Fax: 603-622-4102 |